Can Medication Error be eliminated?

By

TABLE OF CONTENTS

CHAPTER 01: INTRODUCTION1

1.1. Background of the Study1

1.2. Medical Errors3

1.3. Aim and Objectives5

1.4. Research Question5

1.5. Significance of the Study6

CHAPTER 02: SELECTION AND IDENTIFICATION OF THE EVIDENCE7

2.1. Evidence Based Practice7

2.2. Hierarchies of Evidence9

2.3. Search Methodology11

CHAPTER 03: CRITICAL APPRAISAL OF SELECTED EVIDENCE12

3.1. The Articles12

3.2. The Authors12

3.3. The Title13

3.4. The Abstract13

3.6. The Study Background14

3.7. Ethical Considerations14

3.8. Literature Review15

3.9. The Research Design17

3.11. The Sample19

3.12. Data Analysis, Statistics and Results19

3.13. Discussion20

REFERENCES26

APPENDIX30

Summary of Article 130

Summary of Article 231

CASP Model32

CHAPTER 01: INTRODUCTION

1.1. Background of the Study

Medical errors are one of the most pressing concerns in the industry of healthcare. The Institute of Medicine (IOM, 1999) documented increased incidences of medical errors and serious quality-of-care related issues resulting in patient morbidity and mortality. Approximately 44,000 to 98,000 U.S. patients “die in a given year as a result of treatment errors in the healthcare system” (Agresti and Booth, 2000, p. 27). Staff nurses have been known to administer wrong medication at the wrong time and to wrong patients (Donovan and Clayton, 2000, p. 551). Medication errors (2006) involve approximately 1.5 million patients annually and lead to an estimated $3.5 billion in extra medical costs as a result of injuries (Bero and Galbraith, 1992, p. 1135).

Frequently, medical errors have been associated with a lack of cognitive skills (Holmer, 2002, p. 290). “Cognitive skills are those associated with decision-making and management, they involve thinking, reasoning, and the use of knowledge” (Baggs and Schmitt, 1999, p. 1991). A study of the link between medical errors and lack of cognitive skills could provide more in-depth understanding of medical errors as well as the reduction of medical errors (Landow, 2002, p. 290). Critical thinking skills assist healthcare providers, specifically advanced practice nurses (APNs), make sound decisions on how to translate research into practice when faced with complicated problems in clinical practice, thus, potentially reducing medical errors. “Critical thinking involves adults recognizing and researching the assumptions that undergird their thoughts and actions”.

In 2003, to adapt to patient care needs and changes in the U.K. healthcare industry, has acknowledged clinical nurse leadership (CNL) as a new role within nursing (Jaffer and Bednarz, 2009, p. 12). CNLs function as generalists and are master's degree prepared RNs. Primarily, CNLs practice in front-line units within hospitals, outpatient clinics, or home health agencies (Jaffer and Bednarz, 2009, p. 12). As a result of perceived physician shortages in the 1960s, nurse practitioner programs were started in primarily economically deprived areas (Raftery, 1996, p. 163). Nurse practitioners (NPs), known as advanced practice nurses (APNs), are registered nurses (RNs) with advanced clinical training, which includes training in intensive care settings (AAPCOHC). Clinical training for NPs had been obtained either through a certification program or in a combined master's and certification program (AAPCOHC).

NPs work in primary care settings as well as in acute care settings (Baggs and Schmitt, 1999, p. 1991), however, earning less than physicians and spending more time with patients (AAPCOHC). The scope of practice of NPs varies from state to state. In some states, NPs are not ...