Updated: Jul 30th, 2024

Addressing the Problem of Medication Errors Essay

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Summary of Clinical Issue

Medication errors are some of the major factors that contribute to poor patient outcomes. These errors often arise from the lack of sufficient knowledge and experience on the part of nurses, resulting in inappropriate diagnosis and, consequently, wrong prescription of treatment. Some of the negative effects associated with medication errors include prolonged hospital stay, dissatisfaction with the quality of care, development of comorbidities, and higher rates of readmission.

These outcomes seriously impact the patients’ quality of life, create pressure on scarce healthcare facilities (for example, readmissions), and increase the cost of medical care. In the context of worsening nurse shortage and high levels of patient acuity, it is necessary to minimize medication errors as a means of improving patient outcomes.

The starting point in addressing this problem is offering specific training to nurses to improve their competence and efficiency. For instance, training nurses in a specific area of specialization, such as diagnosis, laboratory testing, and drug prescription, can improve accuracy in detecting underlying health conditions. An accurate diagnosis will in turn improve treatment prescription and ultimately lead to better patient outcomes. It is expected that these measures will shorten the length of hospitalization, reduce the rates of readmission, and increase levels of patient satisfaction with care services.

PICOT Question: In patients admitted to Intensive Care Units (ICU), what impact would nurse training have on reducing medication errors and ultimately, minimizing cases of readmission within a few days post-surgery?

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to the prevention of them from nurses and nursing student viewpoints. Global Journal of Health Science, 8(8), 54448.	Pirinen, H., Danielsson-Ojala, R., Lilius, J., Touminen, I., Rodriguez, D. N., & Salantera, S. (2015). Registered nurses’ experiences with the medication administration process. Advances in Nursing, 2015, 1-10.	Zarwe T., Y., Jafaranadi, M. A., & Alinia, T. (2018). Impact of psychosocial factors on the occurrence of medication errors among Tehran public hospitals nurses by evaluating the balance between effort and reward. Safety and Health at Work, 9(4), 447-453.
How Does the Article Relate to the PICOT Question?	The research investigated the cause of medication errors among nurses, which is a relevant line of inquiry concerning the problem the PICOT question seeks to answer. It is after understanding the cause of the problem that appropriate intervention can be formulated.	The research examined the challenges that registered nurses encountered during the medication administration process (MAP). This article is relevant to the PICOT question because inadequate knowledge of MAP procedures is one of the causes of medication errors.	The article is relevant because the researchers examined the impact of the level of nurse motivation on the prevalence of medication errors. Thus, it offers insights on whether improving nurse motivation can result in fewer medication errors.
Quantitative, Qualitative (How do you know?)	The research employed a qualitative approach. The authors asked the participants to describe the issues which they perceived to be contributors to medication errors by nurses.	The research utilized the qualitative approach. This is because it focused on highlighting registered nurses’ views about the MAP procedures and the problems the nurses encountered when administering drugs.	Qualitative. The researchers relied on self-reports by the participants to speculate the influence of psychosocial factors on the likelihood of nurses committing medication errors.
Purpose Statement	To investigate the factors that led to medication errors and how those errors may be prevented, from the point of view of nurse practitioners and student nurses.	To describe how registered nurses understood the different stages of the medical administration process (MAP).	To describe the role that psychosocial factors played in determining the likelihood of nurses committing errors when administering medications.
Research Question	What are the causes of medication errors by nurses, and what strategies may be used to address the errors according to the views of nurses and student nurses?	What is the perception of the medical administration process from the perspective of registered nurses?	What is the impact of psychosocial factors in predicting the occurrence of medication errors by nurses?
Outcome	The participants blamed long working hours and the inability to accurately calculate the required medication dosage.	Registered nurses need help to overcome the various challenges they encounter in each stage of the MAP.	Nurses committed more errors when they felt that their efforts were not rewarded fairly.
Setting (Where did the study take place?)	Khatami-al-anbia Hospital, Zahedan, Iran.	A teaching university hospital in Turku, Finland.	Public hospitals in Tehran, Iran.
Sample	327 nursing staff members and 62 student nurses on internship.	20 registered nurses	379 nurses
Method	Questionnaires.	Questionnaires and interviews.	Questionnaires
Key Findings of the Study	97.8% of the nursing staff blamed long working hours (workload) for medication errors, and 77.4% of the nurse students attributed errors to the inability to accurately calculate drug dosage.	Registered nurses committed medication errors because of ambiguous (equivocal) prescriptions, the inability to utilize technology, and the availability of a wide range of related generic drugs.	29% of the participants reported having committed medication errors in 2015. The majority of the cases were attributed to stress, resulting from the nurses’ perception of an imbalance between their efforts and the rewards they earned.
Recommendations of the Researcher	Reduce working hours for nurses by hiring more nurses to share these workloads and providing new nurses with skills and computerized tools to enable them to determine the correct dosage.	There is a need to train registered nurses on how to write diagnosis reports and drug prescriptions clearly to avoid confusion. Registered nurses also need training on how to follow the MAP procedures when administering medications.	Employers should offer rewards that reflect the number of efforts that nurses put into their work. In addition, there is a need to reduce the workload to address cases of stress related to nursing burnout.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	da Silva, B. A., & Krishnamurthy, M. (2016). The alarming reality of medication error: A patient case and review of Pennsylvania and National data. Journal of Community Hospital Internal Medicine Perspectives, 6(4), 31758.	Bull, E. R., Mason, C., Domingos, F., Santos, L. V., Scott, A., Ademokun, D., Simiao, Z., Oliver, W. M., Joaquim, F. F., & Cavanagh, S. M. (2017). Developing nurse medication safety training in a health partnership in Mozambique using behavioral science. Globalization and Health, 13(1), 45.	Pahlavanzadeh, S., Asgari, Z., & Alimohammadi, N. (2016). Effects of stress management program on the quality of nursing care and intensive care unit nurses. Iranian Journal of Nursing and Midwifery Research, 21(3), 213–218.
How Does the Article Relate to the PICOT Question?	The study examined the effects of medication errors on the patient’s well-being. The findings are relevant in showing that medication errors can lead to serious side effects, hence, the need for proper and adequate training of nurses.	The article explored the potential benefits of conducting workshops aimed at improving medication safety. The research is therefore relevant in demonstrating the positive impact of nurse training on patient outcomes.	The study examined the potential positive impact of stress management training on the performance of critical-care nurses. The findings are significant in demonstrating how stress management can help nurses to avoid medication errors caused by factors like tension, anxiety, and fatigue.
Quantitative, Qualitative (How do you know?)	Quantitative research. The study investigated the prevalence of incidences of medication errors across outpatient care facilities in Pennsylvania and nationally in the United States.	Quantitative. The study measured the participants’ ability to calculate drugs accurately (quantitative). The study also measured the participants’ levels of confidence when prescribing and calculating drugs.	Quantitative. The researchers compared the nurses’ performance before and after training, to determine whether training in stress management led to a better quality of care in intensive care units.
Purpose Statement	To investigate the rate of medication errors in Pennsylvania and the United States in general.	To explore the initial impact of an international health partnership’s work to develop a drug calculation workshop.	To explore the impact of stress management training on the nurses’ performance in critical-care settings.
Research Question	How prevalent are cases of adverse drug events (ADEs) in Pennsylvania and the United States in general?	What impact would international partnership workshops have on nurses’ ability to calculate drugs?	What is the impact of stress management training on the performance of intensive care unity nurses?
Outcome	The study showed that avoidable adverse effects and hospital readmission were caused by the wrong medication.	At the end of the study, participants were able to calculate drug dosages accurately and reported higher levels of confidence in calculating drugs.	The findings indicated that the intervention group improved in terms of quality of care, compared to the control group. The positive changes in the intervention group were evident immediately after the training and 1 month later.
Setting (Where did the study take place?)	An outpatient healthcare facility in Pennsylvania.	Beira Central Hospital (BCH), a referral hospital in Beira, Mozambique.	Al-Zahra Hospital in Isfahan, Iran.
Sample	A case study involving an elderly female patient (aged 71) readmitted with serious complications due to the wrong medication. Analysis of 2.2 million safety reports nationally.	87 Portuguese-speaking nurses from Beira Central Hospital, Mozambique.	65 nurses working in the intensive care unit at Al-Zahra hospital.
Method	Case study and review of medical records.	Questionnaires, interviews, and observations.	Questionnaires and observations.
Key Findings of the Study	Nationally, adverse drug events accounted for 1 in every 30 hospital admissions among the elderly, while the average hospitalized patient experiences at least one medication error each day. Medication errors cause harm to about 1.5 million people in the U.S every year.	After the training, the desire by the participants to use calculators to confirm drug dosage increased by a factor of p= 0.031.	The study group demonstrated better improvements in quality of care than the control group. The intervention group also performed better in physical, communication, and psychosocial measures, compared to participants in the control group.
Recommendations of the Researcher	Improve overall physician communication and transition of care. It was found that most of the ADEs cases could have been avoided if there were effective physician-physician communication.	Strong partnerships are necessary to help nurses working in low-resource settings gain more competence in using digital equipment to calculate drugs.	Critical-care nurses are regularly exposed to traumatic experiences, which can lead to stress. Training nurses working in intensive care units is necessary to enable them to cope with the emotional and psychological pressure associated with their line of work.

References

Bull, E. R., Mason, C., Domingos, F., Santos, L. V., Scott, A., Ademokun, D., Simiao, Z., Oliver, W. M., Joaquim, F. F., & Cavanagh, S. M. (2017). Developing nurse medication safety training in a health partnership in Mozambique using behavioral science. Globalization and Health, 13(1), 45. Web.

da Silva, B. A., & Krishnamurthy, M. (2016). The alarming reality of medication error: A patient case and review of Pennsylvania and National data. Journal of Community Hospital Internal Medicine Perspectives, 6(4), 31758. Web.

Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to the prevention of them from nurses and nursing student viewpoints. Global Journal of Health Science, 8(8), 54448. Web.

Pahlavanzadeh, S., Asgari, Z., & Alimohammadi, N. (2016). Effects of stress management program on the quality of nursing care and intensive care unit nurses. Iranian Journal of Nursing and Midwifery Research, 21(3), 213–218. Web.

Pirinen, H., Danielsson-Ojala, R., Lilius, J., Touminen, I., Rodriguez, D. N., & Salantera, S. (2015). Registered nurses’ experiences with the medication administration process. Advances in Nursing, 2015, 1-10. Web.

Zarwe T., Y., Jafaranadi, M. A., & Alinia, T. (2018). Impact of psychosocial factors on the occurrence of medication errors among Tehran public hospitals nurses by evaluating the balance between effort and reward. Safety and Health at Work, 9(4), 447-453. Web.

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