• Internal Code :
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  • University : James Cook University
  • Subject Name : Nursing

Qualitative Research on Medication Error in Elderly Patients 

Elderly care involves specialized skills from nursing, connected to an appreciation of, the biological, social, psychological, and cultural theories among others that permeate aging. Care is the core of nursing, but a new, changing dimension is being identified in health services, which is the growing demand for treatment for the elderly in this field (Rodrigues, 2014). The use of medication in older adults is frequently ineffective and inaccurate, partly due to the difficulty of prescribing and partly due to other factors in the patient, physician, and health care system that significantly affect the clinical benefit of medication in the elderly. On the one hand, a high incidence of medication errors in elderly people stems from the combination of reasons that lead to medication errors across all ages, such as polypharmacy, polymorbidity, enrolment in multiple disease control services, and service fragmentation (Fialová & Onder, 2009). Different geriatric factors, but at the other side, play a key role in such medication errors; this included age-related pharmacological shifts, lack of clear data on medication safety and efficacy, underuse of systematic geriatric evaluation, less accessibility of dosage forms that give geriatric dosage (Fialová & Onder, 2009). Nevertheless, the question rises about the nurse's perception of medication error in elderly patients.

The nurses have to be particularly careful about the medication error and try to stop repeating the same mistakes. The underreporting of medical mistakes is usually a concern (Poorolajal, Rezaie & Aghighi, 2015) The existing research is aimed at exploring the awareness of nurses regarding medical errors by assessing their attitudes to reporting and examining the obstacles and facilitators involved. The key purpose of giving patient medicine is to help them to regain his/her health without harm. Adverse incidents and medical failures are the biggest risks to the wellbeing of the individual and are uncomfortable conditions in almost all health services (Scott & Henneman, 2017).

The World Health Organization reported that thousands of people experience accidents directly related to medical treatment but many are preventable, while incidence is estimated to be greater in especially in the developing countries. Knowledge of medical errors by health professionals, their perceptions of disclosing medical errors, and implicit obstacles to communication are significant aspects that influenced the nurses' treatment. In general, healthcare professionals and nurses in specific are accountable for medication mistakes during drug administration (Natan et al., 2017). The awareness and perceptions of nurses, as well as obstacles and facilitators to disclosing medical errors amongst nursing staff, are problems that are little explored and require analysis.

Ethical issues are present in every form of science. The study method creates tension between research aims to generalize for the benefit of others, and the rights to privacy of the participants nurses. The ethical considerations about the nurse’s confidentiality and privacy should be taken during the research. Implementing appropriate ethical principles in protecting the shuman subjects like in this case the nurses, can help avoid or minimize harm.. For qualitative study studies, the essence of ethical issues is subtle and distinct compared to issues for quantitative studies (Hammarberg, Kirkman & de Lacey, 2016). For example, there are possible ethical concerns about how a researcher achieves access to interact with the nurses, and about the impact that the researcher can have on respondents.

Nurse researchers need to reconcile both the values of science and client well-being. Qualitative clinical work focuses on people 's interactions in regards to health and disease. But nurse researchers may find that there may be tension between their positions as investigators and as clinicians. Qualitative studies are mostly performed in contexts that require people 's involvement in their daily environments (Ienca et al., 2018). Any work that involves people also needs an understanding of the ethical problems that can be derived from these experiences. Ethics in health research requires appropriate study design, analytical design, and sources of funding, as well as data collection habits.

The use of a qualitative approach (in-depth interviews) offers versatility and consistency in the collection of personal emotions, perceptions, and experiences related to data and, thus, these approaches are used to analyze the perspectives of participants concerning reporting medication errors. Due to anonymity, worthiness, and personal space concerns for shy and reluctant respondents the personal interview approach can be chosen over focus group discussions (Cypress, 2018). This allows the participants the opportunity to elaborate on their responses without disturbances. Nurses would participate simply on voluntarily, and they could be told that they might exit at any point and during the study. The nurses can be interviewed when they have less workload. The nurses are assured to retain their confidentiality and privacy. Even the study team had access to documents of the results the nurses obtained. Once the interviews begin the study objective should be described to each respondent. All attendees are also expected to sign an "informed consent form" accompanied by adding their demographic profile (Kallio et al., 2016).

Usually, in-depth interviews begin with open-ended questions, and then interviewees use additional questions to explore different topics. The researcher must have a guide prepared for each topic, with a list of issues to be discussed including some appropriate questions or probes. The research about nurse’s perception of medication errors can be studied using a qualitative research method where the in-depth interviews can be used to collect the data. The ethical, as well as practical considerations, have to be kept in mind by the researcher so that the actual results can be significant.

References

Cypress, B. (2018). Qualitative research methods: A phenomenological focus. Dimensions of Critical Care Nursing, 37(6), 302-309.

Fialová, D., & Onder, G. (2009). Medication errors in elderly people: contributing factors and future perspectives. British Journal of Clinical Pharmacology, 67(6), 641–645. https://doi.org/10.1111/j.1365-2125.2009.03419.x

Hammarberg, K., Kirkman, M., & de Lacey, S. (2016). Qualitative research methods: When to use them and how to judge them. Human Reproduction, 31(3), 498-501.

Ienca, M., Ferretti, A., Hurst, S., Puhan, M., Lovis, C., & Vayena, E. (2018). Considerations for ethics review of big data health research: A scoping review. PloS One, 13(10), e0204937.

Kallio, H., Pietilä, A. M., Johnson, M., & Kangasniemi, M. (2016). Systematic methodological review: Developing a framework for a qualitative semi‐structured interview guide. Journal of Advanced Nursing, 72(12), 2954-2965.

Natan, M. B., Sharon, I., Mahajna, M., & Mahajna, S. (2017). Factors affecting nursing students' intention to report medication errors: An application of the theory of planned behavior. Nurse Education Today, 58, 38-42.

Poorolajal, J., Rezaie, S., & Aghighi, N. (2015). Barriers to Medical Error Reporting. International Journal of Preventive Medicine, 6, 97. https://doi.org/10.4103/2008-7802.166680

Rodrigues R. A. (2014). Contributions of nursing in elderly care. Revista Latino-Americana De Enfermagem, 22(3), 353–354. https://doi.org/10.1590/0104-1169.0000.2423

Scott, S. S., & Henneman, E. (2017). Underreporting of medical errors. MedSurg Nursing, 26(3), 211-214.

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