Applying Research Skills-Medication Errors

Summary of the Problem

Medication errors are a persistent but preventable issue in healthcare. They majorly occur due to mistakes at any point in the medication process. In nursing, they majorly occur due to insufficient knowledge, workload, interruptions, burnout, and unclear guidelines (Wondmieneh et al., 2020). Medication errors are a problem with significant professional relevance as they have negative impacts on care quality and safety, the provider’s reputation, and negative economic outcomes. I have experienced how medication errors affect patient well-being and put a lot of stress and pressure on the care provider. For instance, I have witnessed minor situations and near misses. However, one case involving a newly employed physician ended up sending the patient to the emergency room as the patient had underlying hemophilia and the medication was blood thinner. This and the other cases made me explore various evidence-based interventions to prevent medication errors and improve the quality and safety I deliver.

Identifying Academic Peer-Reviewed Journal Articles

The identification of academic peer-reviewed journal articles was conducted at the Capella University online library. A cross-database search was also carried out using the Capella University Library’s Summon search functionality. The databases of focus included PubMed Central, a leading medical and healthcare research resource maintained by the National Institutes of Health (NIH), and the Cochrane Library, a resource focused majorly on publishing high-quality, evidence-based systematic reviews. The two databases were used as they allowed access to or provided links to full-text articles as well as allowed search for related articles. Keywords used in the search included “adverse drug events,” “medication reconciliation,” “medication administration,” “medication errors,” and “medication safety.” Since the databases used allowed filtering for search results, filters, including types of articles, were limited to journals, while the publication year was limited to articles published within the last five years.

Assessing Credibility and Relevance of Information Sources

All articles were accessed in terms of their credibility and the relevance of the information they provided on the topic of medication errors. Assessing the credibility and relevance of the articles selected for inclusion first ensured that the article title related to medication errors and the article had been published in a peer-reviewed journal. I then assessed the authority of all authors for each article on the subject of medication errors. This included reviewing their affiliated institutions and roles. I then assessed when the article was published and ensured all articles were published between 2019 and 2023. Additionally, I also checked the methods of research applied and the consistency of the methods and data used. I also reviewed the clarity of the objectives of each article and how each article made recommendations, as well as the limitations the study in each article faced.

Annotated Bibliography

Elliott, R. A., Camacho, E., Jankovic, D., Sculpher, M. J., & Faria, R. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety, 30(2), 96–105. https://doi.org/10.1136/BMJQS-2019-010206

This article analyzes medication errors in England and provides their prevalence at the national level and their clinical and economic burden on the National Health Service (NHS) in England. The article notes that the annual cost of medication errors in England is estimated to be over £237 million, with 38.4% occurring in primary care. Additionally, the study also notes that out of these, 72% are not clinically significant, while 66 million cause notable clinical harm. A majority of these, 34%, are related to errors in prescription. The obviously avoidable errors cost the NHS over £98 million annually and stress the NHS as they add to 181 626 bed-days and cause 1708 deaths. This article is included in this review as it provides both economic and quality of care effects of medication errors. Healthcare providers and policymakers can use the evidence from the article to improve medication processes.

Gates, P. J., Hardie, R. A., Raban, M. Z., Li, L., & Westbrook, J. I. (2021). How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis. Journal of the American Medical Informatics Association, 28(1), 167–176. https://doi.org/10.1093/JAMIA/OCAA230

This article presents a systematic review and meta-analysis of 18 articles aimed at evaluating how the implementation of an electronic medication system (EMS) changes medication error rates and reduces associated patient harm, as well as the actual evidence of the efficacy of EMS within care settings. The study notes that, despite the available evidence on the application of EMS in medication prescription, the evidence has a lot of variability in presenting their findings. Regardless, the authors conclude that the reviewed evidence notes that once implemented in the medication process, the EMS system has the potential to significantly reduce the error rates in medication prescription and administration, as well as the reduction of the medication-error associated harm by 50% and 40%, respectively. This article is relevant and was included as it explores and provides insights into medication errors and associated harm, as well as high-level evidence on the effectiveness of EMS in managing medication administration errors.

Sarfati, L., Ranchon, F., Vantard, N., Schwiertz, V., Larbre, V., Parat, S., Faudel, A., & Rioufol, C. (2019). Human-simulation-based learning to prevent medication error: A systematic review. Journal of Evaluation in Clinical Practice, 25(1), 11–20. https://doi.org/10.1111/JEP.12883

This article presents a systematic review of 21 articles to determine the effectiveness of human simulation in healthcare in reducing medication errors. The study also aims to contribute to the current evidence on improving provider knowledge, skills, and attitudes to reduce medication errors without involving patients in the training. The article notes that human simulation-based learning had a significant effect on the prevention of medication errors. Human-simulation learning helps healthcare providers prevent medication errors by improving their knowledge, skills, and attitudes toward medication safety. The authors conclude that, with proper regulation, human simulation can help healthcare staff improve their skills in preventing events that occur exceptionally, as well as in daily care delivery. The article is relevant and was included as it shows how human factors such as knowledge and attitudes can be integrated into simulation learning to improve the efficiency of healthcare providers in medication error prevention.

Zucker, I., & Prendergast, B. J. (2020). Sex differences in pharmacokinetics predict adverse drug reactions in women. Biology of Sex Differences, 11(1), 1–14. https://doi.org/10.1186/S13293-020-00308-5/TABLES/3

This article presents a study in which the authors aimed to determine how sex differences relate in terms of pharmacokinetics and how sex differences in relation to drug pharmacokinetics can predict adverse drug reaction differences between men and women, with a focus on predicting ADRs in women. The article argues that major drug trials focus on men, leaving a gap in the effects of drug PKs on women. The study found that sex differences in pharmacokinetics have the potential to contribute to adverse drug reactions in women. Notably, the article notes that women, as compared to men, are more likely to suffer from ADRs due to differences in drug metabolism and clearance. The article concludes that sex differences in pharmacokinetics influence ADRs and strongly predict sex-specific ADRs for women but not men. This article is relevant and was selected as it identifies the need to consider the sex of a patient in drug prescription and administration to reduce ADRs among women.

Summary

The process of searching for articles, analyzing their relevance, and developing this annotated bibliography has improved my knowledge of the process of evidence development to inform practice. I have learned how to use keywords, phrases, and other filters to refine my search, as well as how to analyze articles for relevance, quality of evidence, and currency. The main points learned include:

Medication errors are a common and serious problem.

Medication errors significantly impact patients and providers.

Causes are multifactorial.

Prevention focuses on specific causal factors.

The included sources have helped me understand medication errors, contributing factors, and various interventions to prevent their occurrence. Such knowledge is useful in everyday practice on how to develop, implement, and manage strategies to improve overall patient safety.

References

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(1), 1–9. https://doi.org/10.1186/S12912-020-0397-0/TABLES/4

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Question

For this assessment, you will research best practices related to a current healthcare problem.
Your selected problem or issue will be utilized again in Assessment 4. Before you complete the instructions detailed in the courtroom, first select one of the following healthcare problems or issues:

Applying Research Skills-Medication Errors

· Medication Errors
Description: A medication error is a preventable adverse effect of a patient
taking the wrong medication or dosage, whether or not it is evident or harmful to
the patient. Medication errors can be a source of serious patient harm, including
death.
Interventions: Electronic prescribing, pharmacist reviews, patient education.