Evidence based practice

Evidence based practice: Approaches to Reduce Medication Errors
Evidence based practice: Approaches to Reduce Medication Errors
Background of the Problem
The quality of patient care services is a critical factor that enhances the growth of the
nursing profession and the improvement of health provision. Numerous risk factors arise in the
health sector that hinders the effective provision of caregiver attention to patients in different
situations. One of the key challenges is medication related errors that are often experienced in the
hospitals. Medication errors leads to serious economic and health implications including the
spread of hospital-acquired infections (Fleischmann, 2016). Therefore, the evidence-based
prevention policies play a crucial role in helping nurses to incorporate preventive measures in
their clinical practices. Recent statistics depict high levels of adverse events that face patients
who are admitted to hospitals (Schiff et al., 2015). The instances have had a significant effect on
the admitted patients and have led to the extension of hospital stay or also caused disabilities and
further infections to the victims after being discharged. Thus, obtaining efficient intervention
measures that can mitigate the spread and effects of the issues related to patient safety. The
integration of evidence-based practice in the enhancement of patient safety is indispensable since
the problem calls for adequate research on the current measures that will promote effectiveness.
Various studies have been contacted in this area recently that can be used as a premise for further
studies and empirical analysis of the problems to obtain fundamental solutions (Rashleigh-Rolls,
2016). This project is crucial because it aims at combatting one of the primary challenges in the
provision of clinical services and that is patient safety. The area is comprehensive of various
branches that include medication and administrative errors that hinder the safety of the
medication practice. Urgent intervention is required to reduce the medication errors that are
hazardous and poor communication processes among the nurses in practice that causes
inefficiency in clinical practices by analyzing different studies in the respective areas and also
conducting surveys in the field.
Statement of the Problem
Patient safety issues have been on the rise in recently. The process of providing effective
care to patients and promoting recovery has become difficult because of various barriers that
undermine safety. Rashleigh-Rolls (2016) contents that the errors from medication has had an
outstanding effect on the levels of safety among patients. The medication process is
comprehensive of many aspects such as the dosage, prescription, and the maintenance of the
records. A recent study established that over 230 00 medication-related cases are reported in
Australia, which translates to over AU$1.2 spent on such issues every year (Roughead, Semple
& Sosenfeld, 2016). This finding implies that the situation is critical and needs urgent
intervention because the cost is high and the lives of the victims is at stake.
Medication errors have also been reported in an escalating trend. This problem can be
averted by health professionals easily, but the number of cases raised regarding the wrong
prescription and inappropriate medication is alarming. This malpractice endangers the patient’s
life since misinterpretation or wrong use of medical data can have adverse consequences. The
proliferation of information technology in the health sector is another factor that has increased
the instances of communication and related medical errors. Mistakes when handling the
equipment that was supposed to improve the healthcare system are rampant and also pose a
significant threat to patient safety. Therefore, intervention measures are required to enhance the
correction of such issues basing on the fact that problems associated with technology are
relatively new and are often unanticipated.
The significance of the Problem
The highlighted problem has vital implications for clinical practice in various domains.
The enhancement of patient care regarding the safety of healthcare consumers is an issue of
utmost importance. Intervention using the evidence-based practice is possible to prevent the
mortalities and other adverse effects of the problem. A critical analysis of the problem is required
through a comprehensive field study and review of relevant literature to establish the most
suitable mitigation strategies. Obtaining fundamental solutions to the problem can be a
significant milestone in the enhancement of health services provision. The research is relevant to
the patients because it facilitates their safety and security and is also crucial to the health care
system because it also focuses on the security of the health practitioners and fosters good
relationships among the stakeholders in this field.
The premise of the Project
This project is a comprehensive analysis of the problem regarding patient safety and
security. This study focuses on the intervention measures for the prevention of medication errors.
Furthermore, the study will investigate workable strategies that the administrators in the health
sector can use to control the nursing practices to enhance effectiveness. The project is motivated
by the recent statistics that reveal a wide range of cases regarding the highlighted problems
which are in an increasing trend in the healthcare system. Therefore, the project aims at
analyzing the situation in the field and also establishing the proximate causes and intervention
strategies through a review of existing literature. The findings will help the nursing sector to
develop an effective framework that will be used to control the problem and enhance clinical
Assumptions and Definitions
The research project will be based on practical analysis and various assumptions to
enhance effectiveness. The assumptions will help in the development of generalizations that will
be used to derive the integration measures. The following are the key assumptions for this
The surveys will give the correct representation of the situation in the field so that the
evidence can be used to develop intervention strategies.
ii. The conditions of the participants will be a reflection of a significant percentage of
the other health institutions so that the solutions can be applied in a wide range of hospitals.
iii. The findings of previous studies conducted on topics that are relevant to the study
are accurate since their findings will be used to develop a theoretical framework to approach the
research project ("Identifying Assumptions and Limitations for Your Dissertation |
AcademicInfoCenter.com," 2018).
iv. The participants in the interviews will give honest information regardless of their
Literature Review
Previous studies have analyzed issues relating to patient safety critically and generated
proximate causes of the increase in the instances of medication errors that have led to multiple
effects to the victims. According to Barnett et al. (2013), bloodstream infections in hospitals is a
leading cause of death and also contributes to an extended stay of patients in hospitals. The
problem is caused by errors in practicing by the nurses in charge in the treatment centers. Their
findings indicated that most deaths in hospitals were associated with nosocomial infections that
also had a significant impact on the duration that the patients stayed in critical conditions. Prior
researchers have also identified that medication related errors affected patients in acute
conditions leading to mortalities and extended stay in hospitals. (Murni, Duke, Kinney, Daley,
& Soenarto, 2015). The hygiene standard of the caregivers is a probable cause of this instance
and also the quality of protective clothes that they use. The problem is critical and requires
workable intervention strategies to enhance the provision of quality health service. In their
analysis, Murni et al. (2015) observed that multifaceted interventions strategies are vital in
facilitating the reduction of hospital-acquired infections. Other notable measures include, proper
hygiene measures taken by both the patients and the clinical officers (Barnett et al., 2014),
isolation of some patients in the situations where the infections can be transmitted easily
(Cornejo-Juárez et al., 2015) and by adhering to standard precautions (Phu et al., 2016).
The use of evidence-based approaches to foster the development of administrative
reforms that can foster accuracy of the nurses is vital. Mehta et al. (2014) assert that evidence-
based practice is a primary commendation for clinicians that can have profound significance in
obtaining radical solutions for the medication errors that is a significant cause of fatalities.
Researchers have established a wide range of infections that originate in healthcare facilities and
are spread therein (Graves et al., 2012). Various intervention measures have also been found to
be suitable for particular situations. Some analysists propose the physical control such as proper
ventilation and regular cleaning among others. Other measures include washing hands to
enhance hygiene, protective clothing and implementing a system of surveillance (Hall &
Roussel, 2016). These strategies require a collaborative approach between different stakeholders
in the healthcare system. The hospital management plays a crucial role in the implementation of
the physical controls and also ensuring that the directives of clinical practice are followed
Medication errors are rampant in the health care system and increase the risks associated
with patient safety. Roughead, Semple and Sosenfeld (2016) conducted an in-depth analysis to
determine the extent of medication errors in Australia to determine the effects. The study
revealed that the problem of medication errors is widespread in hospitals of different levels in
Australia. A significant challenge is the rate of drug reactions among the patients that is
primarily caused by errors in the medication process. Technological factors that aimed at
reducing the risks have been found to be escalating the mistakes by health practitioners that are
more complex and difficult to handle. The computerization of medical order entry is one of the
risk factors that escalate the occurrence of errors in the processes of administering medication to
patients. The IT-related errors in the healthcare on the rise with recent statistics indicating over
one million recorded cases (Schiff et al., 2015). However, the study by Schiff et al. (2015) cited
that a system that can identify the recurring errors has been established. Also, some of the
technological systems are vulnerable to the mechanical and software problems that make them
prone to errors (Maaskant, 2015). Human factors also contribute to the errors which include the
ignorance of the medics and negligence of some of the protocols. Proper training, the servicing
of the equipment and constant monitoring and testing of the technological systems are some of
the profound measures that can facilitate long-term solutions.
It is evident that intervention measures are required to enhance the current levels of
patient safety. Physical and technological barriers increase the risks of infections among the
patients and the medication errors by medical practitioners. It is observed that these instances
increase mortality rates and require evidence-based intervention strategies to combat them
(Nanji, Patel, Shaikh, Seger, & Bates, 2016). Nosocomial infections are common in patients in
the intensive care unit and is a primary factor that causes death and prolonged stay in hospitals.
Nursing practitioners should follow the guidelines of the clinical practices is prudent since most
of the risk factors can be averted by this means. Also, the problems analyzed different in
magnitude and thus different approaches can be relevant. Besides, conducting empirical studies
in the practical settings to establish evidence-based interventions is a significant measure (Raban,
& Westbrook, 2014). The above literature illustrates some problems that have been discovered
through the studies conducted in the field and also proposed strategies to solve the challenges.
However, the statistics provided depict loopholes that give room for further studies to establish
more profound measures.
Outline of the Project Procedure and the Use of Appropriate Improvement Approach
The project will use both the qualitative and quantitative approaches to obtain
comprehensive data that will give insight into the intervention measures. The analysis will target
clinical practitioners and patients in different ends to determine their conduct in the hospital
setting. Furthermore, the project will establish the more profound protective strategies that can
foster improvement. The procedure will include surveys, interviews and a critical analysis of
secondary and primary data. The findings will be analyzed and evaluated to reach an accurate
conclusion. The integration of the recommendations to the health care system is also an objective
of the project. The findings will have critical measures that can improve the entire health care
system and prevent the risks associated with patient safety.
The analysis seeks to find substantial evidence that links the problems and solution facing
the provision of healthcare services. The conduct of medical officers is a critical factor that
should be analyzed (Blease, Lilienfeld & Kelley, 2016). This project aims at establishing a
system of preventive measures that will be developed through an effective framework that aligns
with the mitigation strategies in the literature review. For instance, a comprehensive system of
attendance and verification should be established such that at least two nurses work together at
any given time to verify the prescriptions and any data that is transfered (Derde et al., 2015).
This can be achieved through a series of checks that will be conducted regularly in the hospitals.
Compulsory procedures should be implemented so that the clinical officers in charge can adhere
to them regarding the preservation of patient records and also the prescription to patients
(Luangasanatip et al., 2015)). All medical practitioners who handle equipment will be trained on
the most recent IT strategies, and the process will be offered regularly as in-service education
(Kalil et al., 2016). The project also aims at developing software that will detect entry errors that
lead to inappropriate medication. Providing the clinical workers with sufficient knowledge about
the intervention measures is a crucial aspect that is central to this project. Therefore, the
evidence-based practice is likely to give the expected results.
The research results will be analyzed and transferred to the application sites where the
strategies will be implemented. The evidenced-based measures will help the clinical officers to
enhance their practices so that the administrative practices will be modified to support accuracy
in practice. Besides, the adoption of the evidence-based practice strategies will monitor the
quality of service delivery by the clinical officers by controlling the problem of medication errors
(Dancer, 2014). The improvements will be a significant boost to the entire health sector and will
also pave the way for more analytical studies that will produce more evidence-based practices
that will facilitate effectiveness in healthcare provision.
Barnett, A. G., Page, K., Campbell, M., Brain, D., Martin, E., Rashleigh-Rolls, R., ... & Paterson,
D. (2014). Changes in healthcare-associated Staphylococcus aureus bloodstream
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Hospital Epidemiology, 35(8), 1029-1036.
Barnett, A. G., Page, K., Campbell, M., Martin, E., Rashleigh-Rolls, R., Halton, K., ... & Graves,
N. (2013). The increased risks of death and extra lengths of hospital and ICU stay from
hospital-acquired bloodstream infections: a casecontrol study. BMJ open, 3(10),
Blease, C. R., Lilienfeld, S. O., & Kelley, J. M. (2016). Evidence-based practice and
psychological treatments: the imperatives of informed consent. Frontiers in
psychology, 7, 1170.
Cornejo-Juárez, P., Vilar-Compte, D., Pérez-Jiménez, C., Namendys-Silva, S. A., Sandoval-
Hernández, S., & Volkow-Fernández, P. (2015). The impact of hospital-acquired
infections with multidrug-resistant bacteria in an oncology intensive care
unit. International Journal of Infectious Diseases, 31, 31-34.
Dancer, S. J. (2014). Controlling hospital-acquired infection: focus on the role of the
environment and new technologies for decontamination. Clinical microbiology
reviews, 27(4), 665-690.
Derde, L. P., Cooper, B. S., Goossens, H., Malhotra-Kumar, S., Willems, R. J., Gniadkowski,
M., ... & Aragão, I. (2014). Interventions to reduce colonisation and transmission of
antimicrobial-resistant bacteria in intensive care units: an interrupted time series study
and cluster randomised trial. The Lancet infectious diseases, 14(1), 31-39.
Fleischmann, C., ThomasRueddel, D. O., Hartmann, M., Hartog, C. S., Welte, T., Heublein, S.,
... & Reinhart, K. (2016). Hospital incidence and mortality rates of sepsis: an analysis of
hospital episode (DRG) statistics in Germany from 2007 to 2013. Deutsches Ärzteblatt
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(2012). Evaluating the economics of the Australian national hand hygiene
initiative. Healthcare Infection, 17(1), 5-10.
Hall, H. R., & Roussel, L. A. (2016). Evidence-based practice. Jones & Bartlett Publishers.
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El Solh, A. A. (2016). Management of adults with hospital-acquired and ventilator-
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acquired infections and improving the rational use of antibiotics in a developing country:
an effectiveness study. Archives of disease in childhood, 100(5), 454-459.
Nanji, K. C., Patel, A., Shaikh, S., Seger, D. L., & Bates, D. W. (2016). Evaluation of
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T. (2016). Burden of hospital acquired infections and antimicrobial use in Vietnamese
adult intensive care units. PLoS One, 11(1), e0147544.
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Rashleigh-Rolls, R. M. (2016). Hospital acquired infections: outbreaks and infection control
interventions, a national descriptive survey (Doctoral dissertation, Queensland University
of Technology).
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