Identifying a Problem, Developing a Question, and Selecting Sources of Literature
- Developing a Question
The components of PICOT
P- In adult patients undergoing knee replacement surgery
I- What is the impact of education
C- Compared to other external factors
O – On the recognition, resolution, and prevention of medication errors
T- During surgery
In adult patients undergoing knee replacement surgery, what is the impact of education compared to other external factors in nursing on the recognition, resolution, and prevention of medication error during surgery?
- Identifying the Problem
In the contemporary healthcare setting, pharmacological concepts are created to ensure the positive therapeutic outcome is achievable, especially for surgery patients while preventing cases of inadequate drug reactions. There are patients who die yearly in medical institutions because of preventable medication mistakes. Medication is a fundamental aspect in a nursing role since it associates with risks. In nursing, caution must be ensured to shun cases of medication mistakes when handling patients undergoing knee replacement surgery. This is because nurse practitioners are responsible in administering medications. A medication error is a common problem in professional practice. Moreover, such medication errors not only result in death cases but also significant financial burden. Medication errors in nursing as a shared problem across various surgical disciplines can be solved through education.
Medication errors have also weakened support and confidence in nursing and the entire healthcare setting. The study will focus on the strategic role that education plays in preventing errors in contemporary nursing, especially when administering medication during knee replacement surgery. It will include the aspects of safe medication delivery to surgery patients, such as the correct dose, right patient, correct route, right drug, and time. The study will analyze the complexity of the nursing role in knee replacement surgery and system factors that may cause medication errors. In present-day nursing, there are fundamental nodes in medication administration where such errors occur. In surgery, they include documenting, administering, and monitoring. Moreover, medication errors happen due to poor handwriting in cases of prescription, especially when handling written or printed orders. Nurse practitioners should be aware of such cases since it may involve dangerous abbreviations in most cases.
Education has demonstrated to be one of the most significant aspects in preventing errors during medication. The study will prove how education is an integral aspect in detecting and solving medication errors. Nurse practitioners involved in medication administration in the contemporary health system are well educated and competent on current medications. Such levels of competency enable nurses to detect cases of error more quickly and intercept, regardless of the source before they reach the intended surgery patients. The application of information technology in handling medication, including handheld computers has facilitated the elimination of overdependence on handwritten order medication. Nurse practitioners have also been able to access standardized medication protocols and policies to assist in avoiding cases of confusion.
Contemporary nursing practice has ensured nurse practitioners who handle knee replacement surgery patients are competent enough to avoid the incidence of medication errors. This improves the general outlook of nursing system. In addition, nurses also promote progressive monitoring of medication error, potential cases through educating fellow nurses on the significance of medication awareness. Moreover, the implementation of medication errors in nursing is a significant aspect in the general healthcare system following the consistent cases of errors that may occur in hospital settings, especially with surgery patients. Healthcare practitioners, handling knee replacement surgery patients should therefore put safety first ahead of timelines, especially nurses. Nurses have to exercise caution when handling medication, and when errors occur, they should report it since there are chances that it could also happen to other patients in related circumstances.
- Selecting Resources
- Chang, Yun-Kyung, R.N., PhD., & Mark, Barbara A, RN, PhD., F.A.A.N. (2009). Antecedents of Severe and Nonsevere Medication Errors. Journal of Nursing Scholarship, 41(1), 70-8.
This article investigates the concept of medication error in nursing practice through evaluating its background. The article uses a longitudinal study in providing statistical data to evaluate the significance of the medication error problem in the United States health care system. The article argues that severe and non-sever medication errors indicate different antecedents. It concludes that prevention studies as part of nursing should be implemented to assist in improving nursing practice.
- Gorman, R. L., Bates, B. A., Benitz, W. E., Burchfield, D. J., & al, e. (2003). Prevention of medication errors in the pediatric inpatient setting. Pediatrics, 112(2), 431-6.
Based on a pediatric inpatient environment, the article reviews the significant steps that should be considered to assist in avoiding any medication error. The report does not provide statistical data to elaborate on the significance of the problem, but highlights the basic rate of error occurrence in the general healthcare sector. According to Gorman, in ensuring cases of medication error is minimal, healthcare environments should have effective programs that can handle reported error occasions based on the competency of nurse practitioners.
- Woods, A., & Doan-Johnson, S. (2002). Executive summary: Toward taxonomy of nursing practice errors. Nursing Management, 33(10), 45-48.
The article argues that nurses have been playing a significant role in the reduction of errors in medication. The article provides statistical data for categorizing errors, and demonstrates the significance of handling the problem efficiently. The article supports the proposed changes to ensure the aspect of medication error is minimized.
- Cleary-Holdforth, J., & Leufer, T. (2013). The strategic role of education in the prevention of medication errors in nursing: Part 2. Nurse Education in Practice, 13(3), 217-220.
The report will assist in analyzing the strategic role that education play in preventing errors during medication in a healthcare setting that handle surgery cases. Pragmatic proposals are presented in relation to the solutions that the study will focus on reducing medication errors in nursing. Moreover, the article evaluates how education assists in preparing nurse practitioners for their specific roles in ensuring a reduction of errors, enhanced patient care, and outcome in the general health care system.
- Payne, C. H., Smith, C. R., Newkirk, L. E., & Hicks, R. W. (2007). Pediatric medication errors in the post anesthesia care unit: Analysis of MEDMARX data. Association of Operating Room Nurses. AORN Journal, 85 (4), 731-40; quiz 741-4. doi:http://dx.doi.org/10.1016/S0001-2092 (07) 60147-1
The article addresses the problem as a common factor in nursing practice. It provides data to exhibit the significance of reducing medication errors based on records from databases. The author uses descriptive statistics in comparing data sets to support the proposed solutions to the issue after highlighting the different causes known to practitioners.
- Primejdie, D. P., Bojita, M. T., Revnic, C., & Popa, A. (2014). Patterns of medication use among Romanian nursing home residents. Pharmacology & Pharmacy, 5(6), 560-569.
The article focuses on the medication patterns as applied in Romanian nursing homes. Medical statistical data from clinical pharmacists are reviewed to demonstrate the significance of the problem. The article supports some of the aforementioned proposed changes meant to ensure medication errors are minimal in nursing.
- Beyea, S. C., Hicks, R. W., & Becker, S. C. (2003). Medication errors in the OR–a secondary analysis of medmarx. Association of Operating Room Nurses.AORN Journal, 77(1), 122-9, 132-4.
In this article, the aspect of errors in medication in the operating room is discussed with a focus on nurse practitioners. It provides statistical information from a collective secondary study report from USP and AORN. The findings give an insight into the common medication errors in nursing and causes meant to assist in developing prevention strategies as proposed in the study.
- Cohen, H. (2004). Pediatric medical errors part 3: Safety strategies medication use system to analyze errors. Pediatric Nursing, 30 (4), 334-5.
In the article, Cohen argues that the most fundamental strategy considered in the healthcare system as a prevention measure for medication errors, especially when handling surgery patients is acknowledging that the process used in nursing administration, pharmacy dispensing, and prescriber ordering apply in the entire medication-use structure. The article uses statistical information in tables to show system failures in the medication administration process that result in cases of drug overdose and death. It concludes by providing vital safety strategies that should be considered as aforementioned in the study proposal.
- Greengold, N. L., Shane, R., Schneider, P., Flynn, E., & al, e. (2003). The impact of dedicated medication nurses on the medication administration error rate. Archives of Internal Medicine, 163 (19), 2359-67.
This article addresses the possible impacts of dedicated medication nurse practitioners on the administration of medication and rate of errors. The study used random study statistical information from two hospitals with surgery setting to examine the significance of the medication problem, and how it can be decreased through dedicated nurses focusing on drug administration process. Moreover, the report proposes similar solutions to the research proposal by suggesting that the use of dedicated nurse practitioners in administering medication does not significantly contribute to error reduction compared to competent and educated nurses.
- Silén-Lipponen, M., Tossavainen, K., Turunen, H., & Smith, A. (2005). Potential errors and their prevention in operating room teamwork as experienced by Finnish, British and American nurses. International Journal of Nursing Practice, 11 (1), 21-32.
The study evaluates some of the most potential medication errors that occur in surgery rooms and the possible solutions as experienced by nurses in Finland, Britain, and America. The article uses statistical information collected using interviews and analyzed through qualitative analysis. The article concludes by proposing that balance of medication error-making should be first recognized as significant in order to learn from them. Moreover, this includes reporting of incidents and adopting a strategic reporting system to handle such cases.
- Cohen, H., Robinson, E. S., & Mandrack, M. (2003). Getting to the root of medication errors: Survey results. Nursing, 33(9), 36-45.
In this article, Cohen analyzes poll results from an investigation of nurse practitioners experiences and attitudes in relation to error in medication administration and reporting of such cases. The article does not provide any statistical data to evaluate the significance of the problem, but supports the proposed changes through discussing the potential implications. It concludes by providing more information on how making medication use a safer process in the health care system.
- Bednar, B., & Latham, C. (2014). The changing landscape of the Nephrology nursing care environment in the United States over the last 45 years. Nephrology Nursing Journal, 41(2), 183-90, 199; quiz 191.
The article focuses on the aspects that have contributed to changing of the US Nephrology nursing care setting. The study involves statistical information that focuses on the aspect of medication administering and nurse practitioner’s contribution to the growth of the healthcare system. The study notes the potential changes in nursing that have assisted in improving health care delivery noting the use of technology as a vital factor.
- Kiersma, M. E., PharmD., Darbyshire, P. L., PharmD., Plake, K. S., PhD., Oswald, C., PharmD., & Walters, B. M., PharmD. (2009). Laboratory session to improve first-year pharmacy students’ knowledge and confidence concerning the prevention of medication errors. American Journal of Pharmaceutical Education, 73(6), 1-99.
This study evaluates the laboratory sessions that could be of significance in improving the awareness and self-confidence of first-year students in relation to the concept of preventing medication errors. It argues that the provision of active education experiences could assist recognize, resolve, and prevent medication errors. The study does not involve statistical information on the problem, but proposes that student awareness of their role in preventing and reducing medication errors through improving their confidence and ability on the subject matter is vital.
- Beyea, S. (2002). Wake-up call–standardization is crucial to eliminating medication errors. Association of Operating Room Nurses. AORN Journal, 75(5), 1010-3.
This study argues that standardization is a critical factor in the elimination of medication errors. Beyea proposes that the development of consensus and application of safe practice concepts of medication administering contributes to potential change nursing practice. However, despite other believing, they can be exempted from such measures. Nurse practitioners and clinicians should work together in ensuring medication process is standardized and error-free.
- Papastrat, Karen, M.S.N., R.N., & Wallace, Sharon, M.S.N., R.N. (2003). Teaching baccalaureate nursing students to prevent medication errors using a problem-based learning approach. Journal of Nursing Education, 42 (10), 459-64.
The article addresses the significance of using the baccalaureate nursing curriculum in teaching students how to prevent medication errors through a problem-based learning approach. This is in order to facilitate a transforming medication administration and error knowledge into practical concepts in a clinical setting. The report does not provide data to evaluate the significance of the problem but proposes that the aforementioned reinforcement will enable the nursing students to employ the critical skills necessary in developing confidence for safe, professional practice potential errors.