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Nursing And Midwifery Research

A medication error can be defined as the failure in the process of treatment that can result in potentially harming the patient. Medication errors may take place throughout the medication-use system right from prescribing a drug to the consumption of drug by a patient. Medication errors are considered to be a serious issue in the world and also one of the most errors that threaten the patients’ safety and are also potential to cause death of them (Gorgich et al. 2016).

This essay aims to critically analyze two research articles that focus on the medication management and medication interruptions. The assessment criteria for the analysis of both of the articles is to assess them on the basis of relevancy of the aim, methodology, results and conclusions of the articles to the topic and analyzing the internal, external, and measurement validity of the articles along with their contribution in clinical practice.

The first research article that is going to be critically analyzed is entitled as “Nurses' experiences with newly acquired knowledge about medication management: A qualitative study” (Hoghaug et al. 2019) and will be referred as study one.

The aim of the study one was to explore the experiences of the nurses regarding the implementation of knowledge that was acquired through a mandatory medication management programme (Hoghaug et al. 2019). The intervention asked the nurses to gain some knowledge by taking part in training programme such as medication management programme to refine their practical skills.

The methodology of the study one is qualitative study. The study involved semi-structured interviews of the nurses. The data was collected by recruiting at one place that was in collaboration with the medication management programme at university hospital, Norway and data saturation technique was used for the screening of the number of respondents that were being interviewed and the data was analyzed thematically.

The results depicted the implementation of medication management programme into the nursing practice have made the nurses more aware of their own knowledge and have bring them more confidence. However, some of the factors were experienced as barriers in implementing the knowledge that was gained from the medication management programme in clinical practice.

The study presented by Aspers & Corte, (2019) states that qualitative approach based research is based on non-numerical and unstructured data. The data includes the notes that have been written by the researcher during the whole period of his observation in the study. It entails interviews and questionnaires.

This qualitative research approach is examined by the help of the internal, external, and measurement validity of the study.

The internal and external validity of a qualitative research article are those concepts that reflect whether the results of the research article are trustworthy as well as meaningful or not. While, the internal validity is associated with how well the research and the study has been conducted in terms of its structure, the external validity is associated with the relevancy of it with the clinical practice and to show how implementable the findings are to the clinical practice (Leung et al, 2015). So, the article is following the correct format which shows its internal validity and as the medication management programme’s implementation into the clinical practice is benefiting the nurses as per their own experiences, this shows that the external validity of the article.

The data was collected by saturation, it occurs when in interviews, the researcher starts hearing the same comments repeatedly and it is then when the data saturation is being reached and the researcher stop collecting anymore information and starts analyzing what has been collected. Saturation functions not at the level of the set of the data as a whole, but with respect to the data that has been provided by an individual participant. This seems to approve a narrower and more individual-oriented viewpoint on the data saturation (Saunders et al. 2018). This shows that the right approach was used while collecting the data was appropriate.

The results were clearly showing the relevancy to the title and the findings of the study are crystal clear and are related to the research question along with providing support each quality as in the result section, clear sub heading relevant to the research question were used having the excellent findings. The research is valuable as the training, and the professional development is potential to the staff enhanced with the skills, attitudes, and knowledge needed for the care However, the factors that act as barriers are also shown in the study that can be kept in mind.

The second research article that is going to be critically analyzed is entitled as “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 will be referred as study second.

The aim of the study second was to evaluate the impact of staff training and wearing safety vests on the medication interruptions and medication preperation. Staff training and wearing safety vests are being considered as a combined intervention on interruptions (Huckels-Baumget et al. 2017). The intervention asked the nurses to wearing safety vests.

The methodology of the study second was qualitative approach and the researchers have performed a pre- and post-interventions pilot-study. They have used direct structured observation of the 26 nurses who were preparing and double-checking the 431 medication doses. Out of these 431 doses 225 were pre-intervention and 206 were post-intervention medications for the population of 36 patients out of which 21 for the pre-intervention and 15 were for the post-intervention. The data was collected for pre-intervention, post-intervention, and the combined pre-post intervention and was observed by a pharmacy student.

The results have shown that there are frequent interruptions during the preparation and double-checking of medications for the nursing staff. Moreover, Interruptions were associated with the medication errors and therefore, represent a risk to the patient safety. This study has successfully evaluated the staff training and wearing safety vests with respect to the reduction of interruptions that are faced during the medication preparation as well as doublechecking. The results have showed a positive effect for the combined hospital-based intervention i.e., pre-post intervention that has staff training combining with wearing of safety vests along with the label that says ‘Do Not Disturb’. This has helped in reducing the potential interruptions during medication preparation and double-checking.

Qualitative study aims to determine the understanding of a phenomenon. It enquires about the experience of a population regarding a definite situation (Eriksen & Frandsen, 2018). The methodology used by the researchers was appropriate as thorough explanation was given. In addition, the researchers have used phenomenological approach. A phenomenological approach is an approach that describes the soul of a phenomenon by investigating it from the viewpoint of the population that has experienced it (Englander, 2016). So, the qualitative methodology was appropriate.

Well informative headings and sub-headings have been used in the article. Usage of headings and sub-headings an article is suitable to divide the different sections of article (Gastel and Day, 2016)

There are three fundamental concepts of generalizability, validity, and reliability of qualitative research, out of which generalizability has not been considered in the article. Generalizability can be defined as the extent up to which the results of a study could be valid, applicable, reliable to other settings also. It can also be termed as external validity (Leung, 2015). This entails internal validation and judgment regarding whether the results of a study will be applicable to a particular group or others also. However, the pilot-study was performed only on a single medical ward at one hospital thus; the findings would not be generalizable to other units, or hospitals.

The article has been depicting both internal and external validity as the structural format of the article is appropriate and as the it is relevant and could be implicated into the clinical practice that will turn out to be beneficial and productive for both the nurses and the patient as well.

Both of the articles are relevant and trustworthy and if implemented in the clinical practice by the nursing then, it will help in reducing the medication interruptions which will turn into the reduction of medication errors too. The implication of medication management programme and staff training and wearing safety vests into the clinical practice has potentially shown the reduction in the medication errors.

Both of the studies are following rigorous methodology for the identification, interpretation, and evaluation of the relevant content to get the desired outcome. The study and the approach used were highly specific for this particular issue and it has successfully established the significant findings.

Presenting the study limitations is certainly a crucial part of any scholarly process. Without limitations, the readers would fully grapple the possible segregated areas or other biases that may have an impact on the results provided (Greener, 2018). However, providing limitations also come under ethical consideration of the scientific inquiry. It makes sure the lucidity of both the research as well as the researchers along with providing the transferability of the methods used. It also supports proper analysis and validation of the findings (Resnik & Shamoo, 2017).  

The study second i.e., the second article has clearly shown its limitations, however, The authors of study one have not concentrated on the limitations of the study and its possible impact on the outcomes. According to Ross & Zaidi (2019), limitations are important for understanding the research findings in the framework, checking the validity and relevancy of the work, and identifying the integrity level to the results of published research. Recognition of limitations needs an elucidation of the meaning, persuade of errors, and validation of problems on the published findings.

References for The Phenomenological Method in Qualitative Psychology

Aspers, P., & Corte, U. (2019). What is qualitative in qualitative research. Qualitative Sociology, 42(2), 139–160. https://doi.org/10.1007/s11133-019-9413-7

Englander, M. (2016). The phenomenological method in qualitative psychology and psychiatry. International Journal of Qualitative Studies on Health and Well-being, 11(1). https://doi.org/10.3402/qhw.v11.30682

Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: A systematic review. Journal of the Medical Library Association, 106(4), 420–431. https://doi.org/10.5195/jmla.2018.345

Gorgich, E. A., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Global Journal of Health Science, 8(8), 54448. https://doi.org/10.5539/gjhs.v8n8p220

Hoghaug, G., Skår, 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. doi: 10.1111/jonm.12491

Leung L. (2015). Validity, reliability, and generalizability in qualitative research. Journal of Family Medicine and Primary Care, 4(3), 324–327. https://doi.org/10.4103/2249-4863.161306

Leung L. (2015). Validity, reliability, and generalizability in qualitative research. Journal of Family Medicine and Primary Care, 4(3), 324-327.

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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