Patient safety has been considered as a central issue in the healthcare system. And, out of all the medical errors, medication errors are considered as the most commonly occurring errors (Lee, 2017). These errors create quite serious as well as complex problems in the clinical practice, particularly in the intensive care units. Medication errors are drug related error that could occur either at the time of prescribing a drug or during the drug administration to a patient. But, out of them errors during the administration of medication are the most common one (Escriva-Gracia, 2019). They results in various negative consequences such as long-term hospital stays, augmented economic burden, and even risks the patient’s life. This is the reason behind the consideration of medication errors as a barometer or indicator regarding patient safety error (Lee, 2017).
This essay aims to critically compare and contrast two research articles that are relevant to the medication interruptions and medication management. The criteria of assessing these two articles would be on the basis of checking the internal, external and the measurement validity of the articles’ aim, methodological approach, results, and conclusions and their contribution in the clinical practice.
The first paper to be critically analyzed here is “Nurses' experiences with newly acquired knowledge about medication management: A qualitative study” (Hoghaug et al. 2019) and this will be referred as paper one throughout the essay.
Paper one aims to investigate the nurses’ experiences with respect to the implementation of knowledge acquired from the medication management program (Hoghaug et al. 2019). The study depicted that nurses were asked to take part in training program to enhance their knowledge. The training program mentioned in the study is the medication management program.
The methodological approach used in paper one is the qualitative approach. For this, semi-structured interviews among the nurses were conducted. The data collection and recruitment was done by collaborating with the medication management program in Norway at the university hospital, while the data was saturated by screening the number of the nurses. The approach used is thematic.
The interventions asked the nurses to actively take part in the training program regarding the medication management for enhancing their knowledge in order to reduce the errors that often create complex health issues to the patients. The interventions will enhance the knowledge of the nurses for drug administration to a patient and the other related medication aspect.
The results of paper one showed that the implementation of such programs like medication management program in clinical practice will help in reducing the rate of errors and will make them more potent in their clinical practice. As nurses play a major role in providing or administering the medication, the chance of errors in case of medication becomes the duty of a nurse. However, there are certain factors that are considered as barriers and challenging during the phase when nurses actually try implementing the acquired knowledge from the medication management program into the practice.
According to Hammarberg, Kirkman & Lacey, (2016) the qualitative and quantitative research methodology are exactly contrasting and represent two diverse viewpoints. In qualitative research approach, individual experiences of a population group are taken. This is for the means of generalisability, so that the results can be universally applicable to other similar groups also. It is the non-numerical data. This is based on the interviews and questionnaires that are conducted during the research. Similarly, in paper one, the qualitative approach has been used as semi-structured interviews were taken. To check the reliability of the qualitative research approach for paper one the internal, external, and measurement validity of the paper will be examined.
The internal validity of a research study could be defined as the extent up to which the study ascertains a trustworthy, reliable, and cause-and-effect relationship between a procedure used or applied and the obtained outcome. It also reflects that either the given research study creates it possible to eradicate the substitute explanations for the findings or not. This generally depends on the methodology of the research study and how thoroughly it has been performed. For this, random selection and randomization are considered to be the approaches to improve the internal validity of the article (Hayashi, Abib & Hoppen, 2019).
The external validity is how well the results of a research study can be predicted to be applied to the other settings i.e., how generalizable the findings are (Hayashi, Abib & Hoppen, 2019).
As per the above evidences, the article is internally as well as externally valid. This is because the random selection was done that depicts the article’s internal validity while, the implementation of training program i.e., the medication management program into the nursing practice and it outcome can be predicted to be applied to the other settings i.e., i.e., the findings show generalizability.
The data collection method that is used in the study is the thematic saturation method, this is the most commonly engaged concept for the estimation of sample sizes in a qualitative study (Guest, Name & Chen, 2020). In paper one, the researcher might have started getting the similar responses and as soon as the similar responses start coming up-to a long time then, it would be considered the reach the point of saturation. And, researcher might have stopped collecting the information (Saunders et al., 2018). The collected data is then analyzed and this is considered to be an appropriate way of data collection method.
A good result section must summarize all the collected findings in a descriptive statistics form and must report on the findings from applicable as well as appropriate inferential analyses. The interpretation of the findings must be aimed to answer the article’s research questions along with showing the research significance (Lang, 2017).
The results of the paper one is summarizing all the collected findings in a descriptive statistics form, the findings are clear and applicable. The interpretation of the findings is aimed to answer the article’s research questions and is clearly showing the research significance.
The second paper to be critically analyzed is “A combined intervention to reduce interruptions during medication preparation and double-checking: a pilot-study evaluating the impact of staff training and safety vests” (Huckels-Baumget et al., 2017) and this is going to be be referred as paper two throughout the study.
Paper two aims to assess the impact of staff training and wearing the safety vests on the medication interruptions and medication preparation. Here, the combined interventions on interruptions are the Staff training and wearing safety vests (Huckels-Baumget et al., 2017).
The methodological approach of paper two is also qualitative approach and for this the researchers have done a pre- and post-interventions pilot-study. Direct structured observation on the sum total of 26 nurses that have been preparing and double-checking the 431 medication doses was done. The intervention in paper two is the wearing of safety vests by the nurses from 431 doses. This was done on the population of 36 patients. 21 for the pre-intervention and the medication for them were 225 and 15 were for the post-intervention and there were 206 medications for them. The data obtained from both of the interventions were demonstrated as pre-post intervention which was later on observed by the pharmacy student.
The headings and sub-headings used in paper two are appropriate and dividing it into different sections (Gastel & Day, 2016). The methodology is appropriate and has used phenomenological approach. A phenomenological approach is focused on individual experiences (Nneubauer, 2019). So, the qualitative methodology used for paper two is appropriate.
Paper two is based on the pilot-study that was only performed on a single medical ward that too at one hospital so, the findings couldn’t be generalizable to other units of hospitals, or even to any other hospitals. So, the study fails to prove the external validity.
The results have evaluated that the staff training and wearing safety vests helps in reducing the interruptions that have been faced during the preparation of the medication. The results are showing a positive effect regarding the combined pre-post intervention that concludes that the staff training combining with wearing of safety vests with the label that shows ‘Do Not Disturb’ helped in dipping the possible interruptions that may occur during the preparation or double-checking of the medication. So, the result is summarizing all the collected findings that are clear and applicable. The interpretation of the findings is aimed to answer the article’s research questions and is clearly showing the research significance.
Overall, both of the articles has shown both the relevance as well as the trustworthiness and if any of them would be incorporated into the practice then, it will help in reducing the the medication errors that will lead to the patient safety such as the results of paper one and paper two’s results has shown that the medication management programme and staff training and the wearing safety vests and double checking respectively when implicated into the practice will help in reducing the medication errors and interruptions.
The methodology of paper one and two are appropriate in order to get the optimal outcome. However, in terms of validity paper one has shown internal and external validity both while, paper two lacks in shoeing internal validity as the results were confined to single hospital settings that could get varied when the setting would be changed.
In terms of limitations, the researchers of paper one has not given any limitations in their study which is an important part that has to be present in a research article while, the researchers of paper two have clearly mentioned the limitations of their study. Presenting limitation is a part of scholarly process (Ross & Bibler-Zaidi, 2019).
Escriva-Gracia, J., Brage-Serrano, R., & Fernandez-Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study. BMC Health Services Research, 19, 640. https://doi.org/10.1186/s12913-019-4481-7
Gastel, B. & Day, R. A. (2016). How to write and publish a Scientific paper. Calfornia: ABC Clio publication.
Guest, G., Namey, E., & Chen, M. (2020). A simple method to assess and report thematic saturation in qualitative research. PLoS ONE 15(5): e0232076. https://doi.org/10.1371/journal.pone.0232076
Hayashi, P., Abib, G., & Hoppen, N. (2019). Validity in qualitative research: A processual approach. The Qualitative Report, 24(1), 98-112. Retrieved from https://nsuworks.nova.edu/tqr/vol24/iss1/8
Hoghaug, G., Skar, R., Tran, T. N., & Schou-Bredal, I. (2019). Nurses' experiences with newly acquired knowledge about medication management: A qualitative study. Journal of Nursing Management, 27(8), 1731–1737. https://doi.org/10.1111/jonm.12864
Huckels-Baumget, S., Niederberger, M., Manser, T., Meier, C., Meyer-Massetti, C. (2017). A combined intervention to reduce interruptions during medication preparation and double-checking: A pilot-study evaluating the impact of staff training and safety vests. Journal of Nursing Management, 25, 539-548. https://doi.org/10.1111/jonm.12491.
Lang, T. A. (2017). Writing a better research article. Journal of Public and Emergency, 1. https://doi.org/10.21037/jphe.2017.11.06.
Lee, E. (2017). Reporting of medication administration errors by nurses in South Korean hospitals, International Journal for Quality in Health Care, 29(5), 728-734. https://doi.org/10.1093/intqhc/mzx096
Neubauer, B. E., Witkop, C. T., & Varpio, L. (2019). How phenomenology can help us learn from the experiences of others. Perspectives on Medical Education, 8(2), 90–97. https://doi.org/10.1007/s40037-019-0509-2
Ross, P. T., & Bibler Zaidi, N. L. (2019). Limited by our limitations. Perspectives on Medical Education, 8(4), 261–264. https://doi.org/10.1007/s40037-019-00530-x
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality & Quantity, 52(4), 1893–1907. https://doi.org/10.1007/s11135-017-0574-8
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