Benchmark: Evidence-Based Practice Project

Benchmark -Evidence-Based Practice Project: Literature Review NUR 550

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The occurrence of medication administration errors hinders effective attainment of quality and safe patient care and outcomes. Medication administration errors are significant safety issue in health care sector, especially when there are different crises affecting healthcare and quality outcomes. The susceptibility of patients to medication administration errors increase with reduced number of healthcare workers against an increase in demand for services due to several factors. Medication administration errors (MAEs) increase the length of stay for critically ill patients and cost of care. Studies demonstrate that leveraging health information technologies that include barcode scanning and other interventions can reduce and prevent the occurrence of these events, especially among the critically ill patients. The purpose of this literature review is to offer a comparison of the articles that supports the evidence-based practice project of using health information technology to reduce the occurrence of medication administration errors among the critically ill patients. The review also identifies the methods used to search the literature and synthesizes it for effective understanding and use for the selected eight articles.

PICOT Statement

The use of health information technology can reduce and prevent the prevalence of medication administration errors (MAEs) among critically ill patients. The use of interventions like barcode scanning and electronic dispensation ensures that human errors that occur during medication dispensation are reduced or minimized, especially the critically-ill patients in different health settings.

PICOT Question for the Evidence-Based Practice Project

Among the critically ill patients (P), does the integration of health information technology (I) compared to conventional medication administration process (C), lead to a reduction in medication administration errors (O) during patient’s stay (T)?

Search Methods of the Literature

Effective search of articles comprises of using appropriate approaches and terms that align with the topic of interest. In this assignment, I employed different yet related strategies to search for the articles that support the EBP project. These included using institutional library to get databases of journals and their published peer-reviewed articles. I used terms like “peer review” and “scholarly works” about medication administration errors. Through these approaches, I obtained the articles that I used in providing this literature review as they support my EBP project. I also ensured that the article meet the criteria of being published within the last five years and are relevant to the nursing context and use.

Synthesis of Literature

Article 1

The first article is by Alotaibi and Federico (2012) who discuss the impacts of health information technology on patient safety. Through a review of present scientific evidence on the effects of health information technologies on improving patient safety, the authors demonstrate the effectiveness of these interventions in reducing medication administration errors. Their findings support the implementation of health information technology to reduce medication errors and mitigate adverse events while increasing compliance to established guidelines in nursing practice. The article supports the PICOT as it shows the interventions that can be used to improve quality care and enhance overall patient safety. The article also supports the PICOT by showing the time frame that facilities can use to attain the benefits of these interventions.

Article 2

The second article by Barakat and Franklin (2020) focuses on the effects of using barcode medication administration (BCMA) on nursing practice activity and workflow. The authors use a qualitative study design in two surgical wards at a large acute facility in London. Through observations, the authors found that BCMA increased the nursing workflow, patient verification and efficiencies in medication administration. The authors are emphatic that the use of barcode and other health information technologies can enhance care delivery by minimizing occurrence of medication administration errors. The article supports the PICOT as it addresses how nurse practitioners handling critically ill patients can use technology-based interventions to enhance workflow and increase efficiencies aimed at mitigating MAEs.

Article 3

The third article is by Alomari et al. (2020) which evaluates the effectiveness of nurse-based interventions in reducing medication errors in pediatric wards. The authors investigate the effects of using bundled interventions to reduce medication administration errors. The author also focused on enhancing nurses’ perspective of medication administration process. Using a quantitative research approach in their selected settings, the authors shows through phased action research that these interventions, including use of health information technology, can reduce medication errors by over 60%. The authors emphasize that these benefits are not impacted by tan increase in the number of patients and prescribed medications. The article supports the PICOT question and statement as it shows the duration and interventions that can be implemented by nursing staff and other professionals to reduce and prevent the occurrence of medication administration errors.

Article 4

The fourth study by Devin et al. (2020) focuses on the effects of health information technologies in reducing prescribing errors in hospitals. The authors also focus on behavioral change techniques linked to HIT implementation that can reduce occurrence of medication errors. using a qualitative approach in different settings, the authors show that HIT prescribing reduces medication errors, especially prescribing errors. The authors’ findings emphasize the need for providers to integrate different approaches to ensuring that medication errors do not occur during the entire medication process. The article supports the EBP PICOT statement as it integrates the use of health information technology as a critical intervention to reducing medication administration errors.

Article 5

The fifth article by Zadvinski et al. (2018) explores the experience of nurses working with health information technology over time in their facilities. Using a longitudinal qualitative study design, the authors demonstrate the effects of nurses embracing technologies in a medical-surgical unit for a period of 18 months. The findings show that personal and organizational issues impact the adoption of HIT. The findings show that change of perception of these technologies is essential in attaining their intended benefits to the organization and patient safety goals. The article supports the PICOT statement as it shows that implementing health information technologies requires time for quality outcomes. Leveraging organizational policies and enhances the ability of nurses to adopt and use these technologies to enhance patient safety and quality outcomes.

Article 6

The study by Naidu and Alicia (2019) aims at evaluating the use of barcode medication administration and electronic medication administration records (e-MAR), outcomes, practice and policies and their effects on nurses in the medication administration duties in their nursing practice areas. Through an annotated literature review, the authors’ findings demonstrate that compliance to these interventions enhance patient safety and reduces reported medication administration errors. The use of these practices and policies also improves the efficiency of the BCMA system. The article is essential as it supports the PICOT by discussing the use of the health information technologies as interventions to reducing and preventing the prevalence of medication administration errors.

Article 7

The study by Jheeta and Franklin (2017) focuses on the how hospital electronic prescribing and medication administration system can enhance medication administration safety. Through an observational design, the authors show that implementation of these interventions encourages the occurrence of certain errors but also mitigates others. The implication is that using these interventions helps in reducing errors and enhancing patient safety. The article supports the PICOT statement as it emphasizes the need to use effective interventions and encourage their applications among all stakeholders in healthcare systems.

Article 8

The article by Härkänen et al. (2019) provides an analytical perspective of reported medication errors and their associated mortality in England and Wales for a period of nine years. The authors analyze medication errors in acute care that lead to death, identify the used drugs and describe the associated characteristics of the medication administration errors. Their findings show that most of deaths occurring due to medication administration errors happen in inpatients and among patients aged over 75 years with errors of omission being the most common form. The article supports the PICOT as it shows that medication errors occur due to several factors and should be addressed through integration of health information technologies.

Comparison of the Articles

The most prevalent issue in all these articles is the adoption of different health information technologies in mitigating and reducing the occurrence of medication administration errors (MAEs). Using an evidence-based practice approach, most of the articles demonstrate the effectiveness of having protocols and policies that supplement the use of technology in healthcare settings among healthcare workers. A majority of these articles use systematic reviews as they are considered the best level of evidence, especially in EBP projects. These reviews provide different interventions that healthcare providers can use to integrate health information technologies and reduce and prevent the occurrence of medication administration errors.

The main themes in these articles include use of medication administration processes, medication administration errors’ occurrence, the role of healthcare workers in embracing these interventions, and the effectiveness of the approaches to reduce medication administration errors. Some of the articles like the one by Jheeta and Franklin (2017) don not emphasize the effectiveness of health information technology in mitigating MAEs. However, the article emphasizes the need to have a multifaceted approach to the use of technologies to enhance care delivery. Each of the article has its unique shortcomings and areas not addressed. However, a common theme also emerges about the need to conduct further research to validate the outcomes and effectiveness of health information technology approaches to reduce and prevent medication administration errors, especially in acute care settings. Each of the article does not contain any controversy as the researchers complied with established guidelines to enhance validity and reliability.

Suggestions for Future Research

A majority of these articles recommend the need for further research on different aspects of the topic. The authors are categorical that while their studies offer evidence based on their research, it is imperative to conduct more studies on different aspects of these technologies to ascertain their overall effectiveness in addressing the issue under consideration (Alomari et al., 2020; Alotaibi & Federico, 2017). Gaps in effective research illustrating the interactions among various interventions and outcomes may require more approaches for better implementation of suggested approaches.

Conclusion

Medication administration errors (MAEs) remain a core concern in attaining better patient safety levels in different care settings. These events affect the quality of care and safety, especially for critically ill patients in hospitals who die for other causes other than their afflicted conditions. Therefore, stakeholders need interventions that leverage the best practices to reduce and prevent the occurrence of these events. The findings from these articles demonstrate the need for nurses and other healthcare workers to implement evidence-based practice interventions to reduce medication administration errors (MAEs). The selected articles show the need for enhance patient care and safety for better outcomes.

 

 

 

 

 

References

Alomari, A., Sheppard-Law, S., Lewis, J. & Wilson, V. (2020). Effectiveness of Clinical Nurses’

interventions in reducing medication errors in a pediatric ward. The Journal of Clinical Nursing, 29(17-18): 3403-3413. https://doi.org/10.1111/jocn.15374

Alotaibi, Y. K. & Federico, F. (2017). The impact of health information technology on patient

safety. Saudi Medical Journal, 38(12):1173-1180. doi: 10.15537/smj.2017.12.20631

Barakat, S. & Franklin, B. D. (2020). An Evaluation of the Impact of Barcode Patient and

Medication Scanning on Nursing Workflow at a UK Teaching Hospital. Pharmacy (Basel), 8(3):148.  doi: 10.3390/pharmacy8030148

Devin, J., Cleary, B. J. & Cullinan, S. (2020). The impact of health information technology on

prescribing errors in hospitals: a systematic review and behavior change technique analysis. BMC Systematic Reviews, 9(275). https://doi.org/10.1186/s13643-020-01510-7

Jheeta, S. & Franklin, B. D. (2017). The impact of a hospital electronic prescribing and

medication administration system on medication administration safety: an observational study. BMC Health Services Research, 17(547). https://doi.org/10.1186/s12913-017-2462-2

Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D.

(2019). Medication administration errors and mortality: Incidents reported in England and Wales between 2007 ̶ 2016. Research in Social and Administrative Pharmacy, 15(7), 858-863. https://doi.org/10.1016/j.sapharm.2018.11.010

Naidu, M.  and Alicia, Y.L.Y. (2019). Impact of Bar-Code Medication Administration and

Electronic Medication Administration Record System in Clinical Practice for an Effective Medication Administration Process. Health, 11, 511-526. https://doi.org/10.4236/health.2019.115044

Zadvinskis, I. M., Smith, J. G., & Yen, P. Y. (2018). Nurses’ experience with health information

technology: Longitudinal qualitative study. JMIR medical informatics, 6(2), e38. doi: 10.2196/medinform.8734

The purpose of this assignment is to write a review of the research articles you evaluated in your Topic 5 “Evidence-Based Practice Project: Evaluation of Literature” assignment. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the literature review in this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.

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In a paper of 1,250-1,500, select eight of the ten articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:

• Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
• Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
• Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
• Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).

Literature Synthesis, Part B

The article by Greenwood et al. (2017) is associated with weaknesses that include its failure to use human subjects to determine the effect of the intervention and use of studies that were prone to bias. However, since there is a shortage in the evidence on the intervention, the article informs the importance of technology in diabetes management. Further, Hashmi and Khan (2018) is associated with the strength that it used human subjects to determine the effect of the intervention. However, it has weaknesses that include the small sample used in the research and lack of direct focus on patients with diabetes. Xu et al. (2018) is superior to the earlier articles due to its use of patients with diabetes. There is also a focus on other metrics of care besides level of Hb A1c. However, the small samples size makes its findings not generalizable to a larger population. Nevertheless, it is an important source of evidence on the efficacy of the intervention in adherence to diabetes treatment. Yoshida et al. (2018) is associated with the strength that it used multiple studies on the topic. The findings can therefore be generalized to a larger population of patients with diabetes. However, it has weaknesses that include lack of use of human subjects and studies that were prone to biases. Lastly, Huang et al. (2019) has the highest level of quality of evidence when compared to the above. This can be seen by the methods that were utilized and minimization of bias through randomization. Therefore, it can be utilized as a vital source of evidence in this research.

Areas of Further Study

The studies addressed above revealed that indeed the use of technology can address the issue of type 2 diabetes in African-Americans. However, the studies did not use African-American patients with type 2 diabetes. Therefore, there is a need for a study that focuses on the use of health information technologies in these patients to bridge the gaps in evidence. Further, the extrapolation of the effectiveness of technology to other populations has not occurred (Hunt, 2015). In addition to focusing on African-American, there is need to conduct studies that will reveal the manner in which the adoption of the aforesaid intervention will affect other populace.

• Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
• Conclusion – Provide a summary statement of what you found in the literature.
• Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper. Benchmark -Evidence-Based Practice Project: Literature Review NUR 550
  

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

3.2: Analyze appropriate research from databases and other information sources to improve health care practices and processes.

Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Benchmark -Evidence-Based Practice Project: Literature Review 175.0

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 70.0%
Introduction 5.0% The clinical issue or problem and PICOT statement are omitted. The clinical issue or problem and PICOT statement are incomplete or incorrect. The clinical issue or problem and PICOT statement are presented. Some aspects are vague. There are minor inaccuracies. The clinical issue or problem and PICOT statement are adequately described. The clinical issue or problem and PICOT statement are thoroughly described. Benchmark -Evidence-Based Practice Project: Literature Review NUR 550

Search Methods 10.0% The search strategy and criteria used in choosing and searching for articles are omitted. The search strategy and criteria used in choosing and searching for articles are only partially described. The search strategy and criteria used in choosing and searching for articles are summarized. More information is needed. The search strategy and criteria used in choosing and searching for articles are described. Some detail is needed for clarity or accuracy. The search strategy and criteria used in choosing and searching for articles is thoroughly described.

Benchmark -Evidence-Based Practice Project: Literature Review NUR 550 Synthesis of Literature 10.0% A paragraph for one or more article is missing. All articles are presented, but the synthesis of literature is incomplete. A summary for each article is presented. The main components (subjects, methods, key findings) are generally discussed. General rationale for how each article supports the PICOT is provided. More information is needed. A paragraph for each article is presented. The main components (subjects, methods, key findings) are adequately discussed, and rationale for how each article supports the PICOT is provided. Some detail is needed for clarity or accuracy. A well-developed paragraph for each article is presented. The main components (subjects, methods, key findings) are thoroughly discussed, and substantial rationale for how each article supports the PICOT is clearly provided.

Comparison of Articles 10.0% One or more article is missing in the comparison. All articles are presented, but the comparison is incomplete. A general comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is presented. Some aspects are unclear. More information is needed. A comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is adequately presented. Some detail is needed for clarity or accuracy. A detailed comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is thoroughly presented.

Suggestions for Future Research 10.0% Identified gaps and areas requiring further research are omitted. Identified gaps and areas requiring further research are only partially presented. Some identified gaps and areas requiring further research are generally discussed. The narrative is generally based on the analysis of the literature. More information is needed. Identified gaps and areas requiring further research are adequately discussed. The narrative is based on the analysis of the literature. Some detail is needed for clarity or accuracy. Identified gaps and areas requiring further research are thoroughly discussed and clearly based on the analysis of the literature. The narrative is insightful and demonstrates an understanding of research analysis necessary for future study.

Conclusion 5.0% The conclusion is omitted. A conclusion is presented but fails to present a summary statement of what was found in the literature. The conclusion presents a vague summary statement of was found in the literature. There are inaccuracies. The conclusion presents an adequate summary statement of what was found in the literature. The conclusion is well-developed and presents a clear and accurate summary statement of what was found in the literature.

Ability to Analyze (C3.2) 10.0% The literature review presented does not demonstrate an ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented does not consistently demonstrate an ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates a general ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates an adequate ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates a strong ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.

Appendix 5.0% The appendix and required resources are omitted. The APA Writing Checklist is attached, but an appendix has not been created. The paper does not reflect the use of the APA Writing Checklist during development The APA Writing Checklist is attached and in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality. The APA Writing Checklist is attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper. The APA Writing Checklist is attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.

Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.

Organization and Effectiveness 20.0%
Thesis Development and Purpose 7.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction 8.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English.

Format 10.0%
Paper Format (Use of appropriate style for the major and assignment) 5.0% Template is not used appropriately or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style. All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correc

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