Factors That Contribute to Medication Errors in Nursing

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Introduction

In this paper, I will be evaluating a literature review research paper that was published in a journal publication. The article titled “A literature review of the individual and system factors that contribute to medication errors in nursing practice” written by Brady et al (2009) is a form of a desk-based review paper that utilizes secondary sources to investigate the extent of medication errors issue in health facilities within the context of nursing practice. In this paper, the authors review the findings of various actual research studies (26 in number), that have previously investigated the phenomenon of medication errors, and which have been published in authoritative publications. In this paper, I will provide a critical analysis of the above-mentioned article from various perspectives.

Utilization of literature review in the article

Notable to mention is that this article utilizes a form of desk-based review that relies solely on secondary sources to investigate the issue of ‘medication errors’. The implication is that the final article has relied on secondary sources that were selected to advance and prove a certain hypothesis regarding the issue under investigation (in this case factors causing medication errors), without having to undertake primary research. As such, in this article, the authors utilize the literature review used to write the article in three major ways: (1) To formulate theories that the paper needs to advance to lay the groundwork of investigating the issues at hand. In this article, Brady et al (2009) have a section on the paper titled “Theoretical approach” whereby the theories of the study are summarized which discusses the major categories of factors that are attributed to medication errors.

Literature review has been used to develop themes through which specific factors that are attributed to medication errors are proposed. Finally, a literature review of sources by the authors in this article has served to prove the hypothesis of the study (which is not implicitly stated), as well as to validate the quality and authenticity of this article which is dependent on the sources used. Since all the sources used in the paper appear to be authoritative, the findings of this article consequently can be surmised to be similarly reliable.

Ethical considerations

As a general rule, every research-oriented study must incorporate very essential considerations of ethics that must be observed throughout the process of the research study. One such ethical issue to consider is referred to as confidentiality and privacy; in this case, the researcher puts in place measures that guarantee the privacy of respondent information that is given in confidence (Gilgun et al, 1997; Newman, 1994). Other ethical considerations have to do with the safety of study subjects or respondents. But since in this case primary sources of data collected from respondents were not utilized given that this is a form of desk-review study, there were no ethical issues that could have been encountered, and consequently no need for ethical considerations.

In any case, no interaction with any study subjects took place. Perhaps, a possible ethical consideration that is to be observed in some of the studies utilizing secondary resources is an objective presentation of various study findings by the authors for purposes of ensuring that the reader arrives at an objective conclusion. In this article, there is no evidence of possible bias by the authors in presenting the findings of secondary sources used in the paper. If anything, its presentations of findings from literature review of various sources appear to be highly objective.

Statistical analysis of data

This article is a form of qualitative study rather than a quantitative one, as such, throughout this paper, the authors of this study apply minimal if any statistical analysis. This is because of two obvious reasons: one, the study relies on a literature review of secondary sources that are mostly qualitative as its source of primary data; secondly, the nature and focus of this study “An investigation of the causes of medical errors”, is an issue that is largely subjective which implies that the best approach of researching it will be through a qualitative study (Brady et al, 2009). So to a large extent, this article relies on qualitative analysis but not a statistical analysis of literature review sources as it is evident in the various categories and types of factors that it identifies to be the major causes of medical errors in the nursing practice.

Nevertheless, the study still utilizes to a lesser extent statistical analysis in its discussions, but this is only limited to the summarization of the research findings highlighted in the actual research studies described in some of the secondary sources used. This is evident in some of the sources used in table 1 where the article lists the findings of all secondary sources used to highlight the strength of these study findings by comparing variables such as samples and research methods among others.

Besides this, the authors have cited statistical analysis of data from various studies throughout the article, but have not done any statistical analysis on the secondary sources that it uses. As such, the statistical analyses provided in this article are from a myriad of study findings from secondary sources. This means that the significance of statistical analysis of this article cannot be independently determined unless they were to be derived from the secondary sources used. And because we are not privy to the whole research studies approaches and methods utilized in this article by Brady et al (2009), then it means we as readers can’t determine the statistical significance of secondary sources used in this article as well.

Compatibility of conclusions and study results

Brady et al (2009), in this article, undertake a very systematic investigation of the study topic which demonstrates a high level of literary analysis. This article is well organized, written, discussed, and presented. As a result, the conclusion derived by the reader is consistent with what is presented by the authors, and would have been expected since the review of various literature sources indicates the same. This is why, first, all the various secondary sources used in this article provide similar findings as regards the causes of medical errors in the nursing practice and most of them propose similar solutions for these factors. Secondly, the authors in this article have been able to provide a clear theoretical perspective for these causes, as well as a group of these factors along similar themes based on literature review which implies previous documentation of the same factors in various studies.

Thirdly, secondary sources which were research-oriented, such as that by Grandell-Niemi et al (2003), Kapborg (1995), and Wright (2007) among others cited in the article, indicate statistical significance on factors identified as causes of medical errors. Finally, the article conclusion is derived from the various studies discussed herein which appear objective. Thus, I must state that these article’s results, as presented adequately, support the conclusion arrived at in the article.

Do the conclusions answer the research questions in the definition of the problem?

Unlike other common research studies, this particular study by Brandy et al. does not have any research questions that have clearly been outlined at the start of the article as would have been expected. This is most likely again because of the nature of the study itself which the authors have undertaken, i.e. a desk-based review of secondary sources. Thus, because this is essentially not a research study per se, the authors perhaps felt there was no need for research questions; instead “aim” of the study is what is provided. While research questions could be several, a study ‘aim’ can only be usually generally stated as is the case in this article.

This article’s research aim is to provide “a review of the empirical literature on factors that contribute to medication errors” (Brady et al, 2009). So as far as this aim is concerned, there is no doubt that not only the conclusion addresses this aim which the authors set out to accomplish in this article from the onset, but the authors have also achieved the same throughout the paper in the discussion of the various studies findings, and have even gone another step to provide recommendations on those “factors that contribute to medication errors” (Brady et al, 2009).

Additionally, there are possible research questions that could be derived from the “implication of nursing management” statement which the authors outline at the start of the article (Brady et al, 2009). This, in general, includes challenges encountered by the various stakeholders in identifying and minimizing medication errors, which the study also adequately addresses as it concludes its presentation. Thus, either way, this article has properly addressed any research questions that could be inferred from the aims and objective of the study, even though no such research questions were formulated for this particular article.

Article Conclusion

Brady et al (2009), in this article, conclude by proposing several recommendations that could be used by key policymakers in addressing the challenges arising from the problem of medication errors which was the focus of the article. In its conclusion, the authors emphasize the challenges that medication errors pose to the safety of patients considering the high rates of morbidity and mortality prevalence that is attributed to this phenomenon. The article also reiterates the major factors that it has identified as the leading causes of medication errors, and in so doing demonstrates the importance of the study done here which reviews different studies to provide a single framework that discusses the issue of medication error and, consequently, a common strategy of overcoming the challenges identified. Besides, the article in its conclusion has been addressed fully and met the aim of the study as initially stated. Thus, based on this, I must say this article has indeed provided a conclusion that is consistent with the study objective and which also has met my expectations.

Effectiveness of the study

As far as this journal study is concerned, I would say that the observations of the author’s study discussions and conclusion as arrived in the article would indicate quality and reliable literature review of sources discussed. Consequently, the efficacy of the study in tackling the topic of ‘medication errors’, has been well demonstrated and accurately portrayed. However, since this article’s findings and conclusion rely completely on a range of other research studies done on the same topic (secondary sources), then I must say that the effectiveness of this study is only as accurate as of the sources that have been used throughout this article.

References

Brady, A., Malone, A., & Fleming, S. (2009). A literature review of the individual and systems factors that contribute to medication errors in nursing practice. Journal of Nursing Management, 17, 679–697.

Gilgun, K., Daly, S., & Handel, G. (1997). Qualitative Methods in Family Research. London: Sage Publications.

Newman, L. (1994). Social Research Methods. Boston: Allys & Bacons.

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