Essay Example on Medical Error and Registered Nurse

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Parry, A. M., Barriball, K. L., & While, A. E. (2015). Factors contributing to Registered Nurse medication administration error: A narrative review. International Journal of Nursing Studies, 52(1), 403420.

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In a study to explore the factors that contribute to medication errors in registered nurses, the authors gathered relevant articles on the topic from various electronic databases. Out of 1127 articles identified, 26 were chosen for narrative review. The review methods used included thematic analysis and narrative synthesis. Following the review, it was established that several environmental and personal factors contribute to medication errors. The environmental factors identified included clinical workload and work setting. On the other hand, the personal factors identified included Registered Nurses characteristics and their work experiences.

One of the strengths of the article is that the authors reviewed papers related to the research objective. Secondly, the articles were picked from credible databases using keywords relevant to the research objective. Also, the authors used inclusion criteria to eliminate irrelevant articles. Moreover, the authors provided a summary of all the papers used in the review. Despite the strengths stated, the study had some limitations. For instance, the researchers searched and used English language articles only. Also, the articles were only from countries with advanced healthcare systems. Therefore, it is not known if the studies from countries with less advanced healthcare systems will yield the same results. Another limitation is the small size of articles reviewed. After reading the article, I appreciated the need to address registered nurse shortage so as to reduce medical errors.

Alsulami, Z., Conroy, S., & Choonara, I. (2013). Medication errors in the Middle East countries: a systematic review of the literature. European journal of clinical pharmacology, 69(4), 995-1008.

The researchers used systematically reviewed literature to find out the major factors causing medical errors as well as the prevalence and types of medical errors. Relevant articles were obtained from electronic databases. Articles selected cut across all ages, languages, and types of studies. Apart from electronic databases, the authors manually searched relevant articles. All the search terms or keywords used related to medical errors. All the articles chosen underwent thorough quality assessment. The review was conducted according to the type of medical error. Results from the review showed that there was inadequate evaluation of dispensing and documentation errors. Furthermore, prescribing errors and inadequate knowledge of medicines were found in the studies reviewed. Following these findings, I recommend that nurses should have on-the-job retraining in clinical pharmacology.

Unlike the first annotated bibliography above, the current study included articles written in all languages. Also, the articles chosen were not limited to the time of publication or type of study design. Moreover, more relevant articles were obtained through hand-searching, unlike the first cited article which employed electronic searches only. Therefore, the current is of higher quality than the first one. A limitation of the current study is that databases used were mostly from English language studies.

Middel, B. (2010). The effect of work hours on adverse events and errors in health care. Nederlands Tijdschrift voor Evidence Based Practice, 8(4), 10-11.

The authors used data on nurses characteristics and work hours to investigate whether work hours had an impact on adverse events and errors in health care. The methodological approach was secondary analysis of surveys. Results obtained from data analysis revealed that nurses had more than one type of overtime every week. Also, the respondents reported having had sharp injuries and adverse events (e.g. wrong medication, patient falls, occupational injuries, and work-related infections) in the past year. To find out whether working hours and overtime affected adverse events and errors, multivariate logistic regression analysis was conducted. The results of this analysis showed that overtime work contributed to adverse events and errors. On average, nurses who worked for a longer time (more than 40 hours per week) had higher incidences of adverse events and errors. Based on the findings, it is important that health care policymakers review the overtime legislation. Specifically, I would recommend that the law is scrapped as it has had harmful impacts on patients and nurses safety.

The article has strengths and limitations. The first strength is related to the sample size. Unlike the previously cited articles, the study used a large sample size (11,516 registered nurses). A large sample size increases the external validity of the research. Some limitations of the study include the age of the data and unclear definition of work variables.

Gaffney, T. A., Hatcher, B. J., Milligan, R., & Trickey, A. (2016). Enhancing Patient Safety: Factors Influencing Medical Error Recovery among Medical-Surgical Nurses. Online Journal of Issues in Nursing, 21(3).

In this study, the authors investigated the relationship between RN characteristics and recovery of medical errors among nurses. The inclusion criteria for recruitment of respondents was currently employed nurses who were able to read and write in English. To answer the studys research questions, the researchers gathered nurses data and recovered medical errors data using various self-reported survey instruments. Data analysis conducted in SPSS revealed that nurses with higher education levels and expertise had higher medical error recovery rates. However, no relationship was found between medical error recovery rates and other personality e.g. age, specialty, and certification. Also, nurses with higher patient ratios were found to recover fewer errors. From these findings, I learned that highly qualified nurses provide better patient care and thus there is a need for nurses to acquire higher levels of nursing education. Moreover, I found out that there is a need to increase nurse-patient-ratios if quality patient care is to be achieved.

The study has certain strengths and limitations. One of the strengths is that the self-reported survey instruments used to gather relevant data were both valid and reliable. For instance, Recovered Medical Error Inventory (RMEI) scale used to collected data on medical errors was reported to have a reliability of 0.90. Moreover, RMEI instrument was developed by experts in the medical field and thus highly valid. Also, Ten-Item Personality Inventory (TIPI) scale used to collect nurses data had a correlation of 0.72 across five domains. The limitations of the study included the use of non-random sampling techniques in recruiting the participants and low response rates.

Gaffney, T. A., Hatcher, B. J., & Milligan, R. (2016). Nurses' role in medical error recovery: an integrative review. Journal of clinical nursing.

To understand the role played by nurses in medical error recovery, the authors conducted an integrative literature review. The researchers gathered data from various electronic databases using key search terms related to medical errors. Studies employing various study designs and authored in English were picked for the review. Letters to the editor and dissertation were not included in the review. Following the review, the authors found out that nurses used knowledge of the patient, the environment, and care plan in medical error recovery. Moreover, the review revealed that medical error recovery rates in different specialties of nursing vary. After reading the article, I learned that nurses play a critical role in medical error recovery. Given the importance of medical error recovery, there is a need to identify and nurture the factors or personal attributes that make a nurse better in this area.

One of the strengths of the study is the quality of articles chosen for the review. To ensure that only articles of high quality were selected, the authors assessed their quality using The Johns Hopkins Nursing Quality of Evidence Appraisal process. The authors also provided summary tables of all the articles used in the review. Moreover, the articles were picked from credible databases. The limitations of the study include search strategy limited to articles authored in English and the use of peer-reviewed papers only.

Lewis, E. J., Baernholdt, M. B., Yan, G., & Guterbock, T. G. (2015). Relationship of adverse events and support to RN burnout. Journal of nursing care quality, 30(2), 144-152.

Studies have shown that RN nurses can also be harmed as a result their involvement in medical errors. Using a cross-sectional survey design, the authors sought to investigate nurses engagement in adverse events and its relationship with burnout. Data was collected using self-reported survey instruments and analysis conducted in SPSS 20. The results of data analysis indicated that there is a relationship between nurses engagement in preventable adverse effects and two burn out domains (higher emotional exhaustion and depersonalization). Also, provision of support to nurses involved in adverse events was found to lead to a decrease in their emotional exhaustion and depersonalization leading to personal success.

One of the strengths of the study is that the authors reported the reliability the measurement instruments used. For example, Maslach Burnout InventoryHuman Service Scale used to measure registered nurses burnout was found to have high Cronbach's Alpha reliability of 0.92, 0.77, and 0.79 across the three domains that the instrument assesses. On the other hand, one of the limitations of the study included low response rates. Secondly, non-random sampling of respondents affects the generalizability of findings. Lastly, there was a failure to establish cause and effect given that cross-sectional data was used in the study.

Hwang, J. I., & Park, H. A. (2014). Nurses perception of ethical climate, medical error experience and intent-to-leave. Nursing Ethics, 21(1), 28-42.

The authors investigated whether an association existed between perceptions of ethical climate and nurses involvement in medical errors. They also sought to examine whether ethical climate and medical errors impacted the nurses intent to leave. The data was collected using self-reported survey instruments. Results of data analysis showed that medical error was common among all nurses with 25% reporting their intent to leave their job as a result. Also, nurses with more positive perception of ethical climate had fewer incidences of medical errors and were less likely to leave their job. After reading the article, I recommend that hospital managers should come up with ways of cultivating a positive perception of ethical climate in their employees (nurses) as this will enhance the quality of care of patients by reducing medical errors and nurses turnover.

The study has some strengths and limitations. The first strength pertains the high reliability of survey instrument used. Specifically, the authors reported that Hospital Ethical Climate Survey (HECS), which measures nurses perception of ethical climate, had excellent internal consistency reliability (Cronbachs alpha .95). Secondly, a high response of 77.4% was achieved. Thirdly, the study had a large sample (n= 1826). On the other hand, the studys limitation included the use of non-random sampling methods to recruit participants which reduce studys external validity. Second, the use of a questionnaire to measure nurses experience of medical errors led to possible recall bias.

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