Medical Errors and Patient Outcome

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Table of Contents

PICOT Question
Research Backgrounds
The Literature Support for Reduction of Medication Errors
Methods of Study
Results of the Studies
Conclusion
References

Prolonged hospital stays, dissatisfaction of patients with care provided, development of medical conditions, and cases of readmission are some of the negative consequences of medical errors. Therefore, training of nurses to reduce cases of medical errors can be used to improve patient outcomes through competence and efficiency in their operation. Competent nurses perform correct diagnosis, proper care, and giving of the fitting prescription reduce medical errors and improve patient outcomes.

PICOT Question

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

Research Backgrounds

Four articles on the role of nurse training in reducing medical errors are examined. Gorgich et al. (2016) note that medication mistakes are a genuine worldwide problem affecting medical care, compromising patient wellbeing, and can lead to death. The study is critical to nurses since it improves their comprehension of possible medical mistakes and proper systems to stop them. The motivation and goal of the study were to research different elements that lead to the occurrence of treatment mistakes and strategies which can be executed to minimize the errors based on the nurses’ point of view. The research question that guided the study is: What viewpoints lead to medical errors and which procedures can help minimize them based on the nurses’ and nursing students’ point of view?

Experience of registered nurses and application of technologies assist in reduction of errors. Pirinen et al. (2015) examine the experiences of registered nurses (RNs) in the process of medication administration. The study notes that nurses are involved in all levels of the medication administration process (MAP). Therefore, the competence of nurses can eliminate or reduce medical errors at any stage. The significance of the article to the nursing profession is in providing evidence that the improvement of nursing care determines the quality of care and patient outcomes. The study’s motivations and objectives were to depict how registered nurses work in different stages in the MAP. Pirinen et al. (2015) additionally intend to apply innovative technologies to build up a medication management process that reduces medication errors. The research question that guided the study is: What is the registered nurses’ view of the prescription organization measure?

In addition, examination of medical errors in different settings allow for better understanding of the problem. Bull et al. (2017) investigate mistakes in medication administration in developing nations. The research adds new information to the advancement of drug administration workshops. The study’s purpose is to the improvement of drug calculation capability of nurses in developing economies. The objectives that Bull et al. (2017) sought to achieve include investigating worldwide health partnerships’ commitments to the making of medication drug-dosage. The other goal was to understand learning opportunities and define health psychologists’ role in supporting nurse educators’ work to implement behavioral research into training. The research question relates to worldwide organization workshops’ effect on attendants’ capacity to calculate drug dosage.

Lasty, work environment can lead to stress which results in occurrence of errors. The study by Pahlavanzadeh et al. (2016) examines the issue of work environment stress in ICU attendants and its hurtful consequences to medical care quality. The findings of the article apply to nursing since they describe the viability of a nursing training program in stress management. The goal of Pahlavanzadeh et al. (2016) is advancing effective stress management training by examining the impacts of a ten-meeting program on the nature of ICU nurses’ work. The research examines the effects of stress management on care quality determined through a comparison of care quality in the intervention and control groups.

The Literature Support for Reduction of Medication Errors

All four articles support the research proposed through the PICOT question. The research of Gorgich et al. (2016) is relevant as it examines factors impacting the nurses’ role in medical mistakes. Similarly, nurses in emergency units can identify the possible dangers of committing medication errors and rectify them. Pirinen et al. (2015) provide the evidence necessary to answering the PICOT question by recognizing nurses’ difficulties at different phases of the MAP. Outstandingly, the experiences can be brought about by numerous components, including insufficient information on MAP, prompting medical errors. However, as per the PICOT question, the intervention will prepare nurses on ways to limit medical errors. The control group will also contain nurses who will not be involved in the training program.

Additionally, the study will provide information for addressing the PICOT question as it uses insights that exhibit positive connections between the usage of drug dosage calculation and nurses’ trust in their dose computation skills (Bull et al., 2017). Its findings suggest that nurses’ certainty and revived information after the training would diminish unintentional dosage errors in the populace described in the PICOT question. Pahlavanzadeh et al. (2016) exhibit that nurse preparation on stress management improves nursing care at ICU leading to better patient outcomes. The findings provide evidence to answer the PICOT because of the similarities between the identified problem (prescription mistakes and care quality) and recommend that nurse training would lead to better nursing care and fewer medical mistakes. In both Pahlavanzadeh et al. (2016) study and the PICOT, the intervention and comparison groups demonstrate ICU nurses that have or have not been trained, making this article’s level of relevance to the PICOT extremely high.

Methods of Study

Two of the selected articles applied qualitative methods and the other two quantitative research. Gorgich et al. (2016) and Pirinen et al. (2015) used qualitative design but varied on data collection methods. For Grgich et al. (2016), questionnaires were administered to the study population while Pirinen et al. (2015) used both questionnaires and interviews. Gorgich et al. (2016) have three sections with the first being an elaborate subjects’ demographics, section two is on reasons for medication mistakes, and the last section is on methods of forestalling clinical mistakes as per the respondents’ perspectives. Pirinen et al. (2015) conducted individual thematic interviews with the respondents who additionally filled the questionnaire that had three questions and gave them to the researchers. It also encourages the translation of their activities (Rahman, 2017). However, intricacy in data examination and interpretation is one restriction related to the technique.

Quantitative studies on the field provide evidence on how to reduce medical errors. Bull et al. (2017) utilize quantitative medication estimation and the questions of certainty and goals are included in their nurse schooling tool developed. In contrast, Pahlavanzadeh et al. (2016) name one two-section (segment and care quality inquiries) quantitative tool utilized as a post-intervention and subsequent survey. In the study of Bull et al. (2017), the survey incorporates inquiries from a standard quantitative device affirmed for the estimation of nursing care quality. The limitations of Bull et al. (2017) techniques include an absence of nuanced answers for surveys, time expenditures for semi-organized questionnaires, and the dangers of bias. The advantages are reasonable cost and the capacity to investigate the believes and practices for interviews and observations. The advantage of the method used by Pahlavanzadeh et al. (2016) is the capacity to evaluate the outcomes effectively, which permits the examination of huge populations. The potential restriction is an absence of individual contact with members to stop the error of inquiries or terms.

Results of the Studies

Results

Results of the four studies suggest that nursing education can reduce the chances of the occurrence of medical errors. Bull et al. (2017) observe that a training package aimed at improving hospital nurses’ medication calculation skills helped reduce medical errors. Likewise, Pahlavanzadeh et al. (2016) report positive impacts of their stress management training program on nursing care. The quality of nursing care scores in the mediation group was expanded immediately and a month after the intercession whenever contrasted with the pre-mediation scores and the scores in the correlation group. The findings of the Gorgich et al. (2016) study recognized the most well-known elements that add to prescription mistakes. More than 65 % of the members demonstrated that tiredness because of high job burden, more patients with critical ailments, damaged and indiscernible prescriptions, and natural interruptions caused medical mistakes in nursing. However, Pirinen et al. (2015) uncovered different difficulties experienced by enrolled attendants, which can prompt clinical errors to include technology malfunctions and problems in communication.

Implications

The four articles’ results show that most factors that cause medical errors in medical institutions are preventable. Furthermore, medical institutions’ administration can execute fitting systems to limit the occurrence of medical mistakes. For example, the executives can build the number of medical caretakers and working hours to lighten weariness. Similarly, they may build up a program for informing all nurses on causal factors for mistakes in clinical prescriptions and curative methodologies.

Ethical Considerations

Informed consent and willful participation are fundamental ethical factors in research. The two require all subjects in any examination to have full information concerning it. Respondents need to know the examination’s motivation, the individuals of groups financing it, and how the outcomes will be used. Gorgich et al. (2016) and Pirinen et al. (2015) report that all the participants were informed about the aims of the study and how the information they would provide would be used. Therefore, the researchers fully informed the respondents about the purpose the data they provided. Pahlavanzadeh et al. (2016) had the respondents sign informed consent forms while Bull et al. (2017) explain that all the respondents were given the choice of opting out of the study at any point. Therefore, informed consent and willful participation are covered in the articles examined.

Outcome Comparison

Expected results for the PICOT question are that the utilization of training programs for ICU nurses to accentuate drug prescriptions will improve these experts’ pharmacological information and medicine organization abilities. Therefore, improved aptitudes will probably prompt fewer drug mistakes and readmission of post-medical procedure patients. To address moral contemplations, it will be basic to get the endorsement from neighborhood morals advisory groups and guarantee members’ obscurity. The findings of all for articles examined are similar to what is expected from answering the PICOT question.

Conclusion

The different studies indicate that the inclusion of lessons on the elimination of medical errors can reduce the number of mistakes in patient care. The studies indicate that practitioners are involved in all levels of patient care. Furthermore, the competence of nurses determine the quality of care and patient outcomes in the health care setting. Therefore, the expected findings of the PICOT question are supported by the findings of all the four studies.

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), 1-10.

Gorgich, E. A.C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint.Global Journal of Health Science, 8(8), 220-227.

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.

Pirinen, H., Kauhanen, L., Danielsson-Ojala, R., Lilius, J., Tuominen, I., Díaz Rodríguez, N., & Salanterä, S. (2015). Registered nurses’ experiences with the medication administration process. Advances in Nursing, 2015, 941589.

Rahman, S. (2017). The advantages and disadvantages of using qualitative and quantitative approaches and methods in language “testing and assessment” research: A literature review. Journal of Education and Learning, 6(1), 102-112.

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