Week 7: Assignment – Part 3: Literature Review and Critical Appraisal
This week’s first assignment is STEP 3 – Literature Review and Critical Appraisal.
The student will complete the following items and submit a Word doc to the assignment link.
Provide a title that conveys or describes the assignment.
Literature Review – Provide the key terms used to guide the search for the evidence and provide at least five (5) summaries of research studies to support the evidence.
Critical Appraisal of Literature – Discuss the strengths and weaknesses of the evidence, what is known from the evidence, and any gaps in knowledge from the research evidence.
References – Cite a minimum of five scholarly references in APA 7th ed format.
Also check: Week 7: Assignment – Reflection in Action Paper
Week 7: Assignment – Part 3: Literature Review and Critical Appraisal
Patients visit healthcare facilities to seek healthcare services, which they hope to improve their well-being and health outcomes. However, certain factors hinder safe and effective care delivery to patients, thereby putting their lives at risk. Some of these include medication errors and patient falls within health facilities. Medication errors are among the causes of mortality globally, despite being preventable. Various studies have been done to determine the link between various contributing factors and the incidences of medication errors. Literature Review and Critical Appraisal.
This paper reviews various pieces of literature and critical appraisal of research articles that link nurse-to-patient ratio to incidences of medication errors. The clinical question which the various literature analyzes is; for patients admitted within a health facility (P), dose reduction of nurse-to-patient ratio (I) compared to failure to take a corrective measure in addressing nurse shortage (C) help in preventing medication errors and associated complications (O) within six months (T)?
Specific keywords were used to narrow down the search and to help in ensuring that the sources used were reliable and relevant. This was in addition to ascertaining that the articles met the credibility criteria, which included; being from a reliable website, written by experts in the medical field certified to do so, and timeliness which was to be within the past five years to ensure that the information provided in the articles are relevant, and updated with the most recent studies. Literature Review and Critical Appraisal. The key terms were; medication errors, nurse-to-patient ratio, nursing staff shortage and patient health outcomes. With the key terms, five research studies were analyzed and summarized below.
Izadpanah et al. (2018), in the article, Assessment of frequency and causes of medication errors in paediatrics and emergency wards of teaching hospitals affiliated with Tehran University of Medical Sciences, describe a study done to determine the link between nurse shortage and medication errors. A cross-sectional descriptive study was conducted to determine the type, frequency, and causes of medication errors in pediatric and emergency wards belonging to Tehran University of Medical Sciences in 2017. Literature Review and Critical Appraisal.
Four hundred twenty-three nurses were involved and were selected using the stratified sampling method. The results indicated various causes of medication errors, with a shortage of manpower and high workload being among the commonest causes. The study concluded the need to ensure an adequate workforce to minimize the incidences of medication errors. However, the major limitation was the fear of retaliation, which could have hindered accurate and exact reporting of all incidences of errors and their causes by the nurses.Literature Review and Critical Appraisal.
SHoHani & Tavan (2018), in the article Factors affecting medication errors from the perspective of nursing staff, describe a study done to determine the various factors that affect medication errors frequency from nurses’ perspective across multiple education hospitals in IIam, Iran. It was a descriptive-analytical study with 120 nurses who were randomly selected. Literature Review and Critical Appraisal.
The findings ranked nurses’ fatigue and heavy workload as the leading causes of medication errors in the different facilities. Therefore, the study recommended the need for adequate staffing to reduce the workload to prevent medication errors. The major limitation in this study was also self-reporting of incidences of medication errors by nurses; hence the results may not be the true reflection. Literature Review and Critical Appraisal.
Hammoudi et al. (2018), in the article, Factors associated with medication administration errors and why nurses fail to report them, describe a study done to determine the various contributing factors to the occurrence and reporting of medication errors. A descriptive cross-sectional study involving 367 nurses randomly selected from public hospitals. The findings revealed inadequate nurse staffing as the third leading cause of medication errors after improper packaging and miscommunication between physicians and nurses. The main limitation was inaccurate reporting from nurses due to fear of the consequences, which could have limited the study’s accuracy.
Piroozi et al. (2019, in the article, Frequency and potential causes of medication errors from nurses’ viewpoint in hospitals affiliated with a medical sciences university in Iran, describe a study conducted to investigate the prevalence of medication errors and associated factors among nurses of Kurdistan University of Medical Sciences (KUMS) in 2016. It was a cross-sectional and descriptive-analytic study involving 503 nurses selected using the census method. Heavy workload and prolonged working hours were the significant causes of medication errors, hence the recommendation for addressing these.
Zarea et al. (2018), in the article, Iranian nurses’ medication errors: A survey of the types, the causes, and the related factors, describe a study done to assess nurses’ medication errors and the related factors. It was a cross-sectional descriptive-analytical study; involving 225 nurses selected using multistage random sampling. The findings identified heavy workload, inadequate staff and fatigue among the caregivers as fundamental causes of medication errors.
Critical Appraisal of Literature
The literature shows a strong link between medication errors and nurse-to-patient ratio. When the ratio is higher, nurses get fatigued due to heavy workload, hence increased likelihood of committing errors. The studies have all confirmed the existing link between nurse shortage and medication errors and recommended actions to help in preventing more errors. The major weakness is the limitation surrounding the studies revolving around reporting of cases of medication errors by nurses. Therefore further research and studies should be done with this in consideration for more accurate and reliable results.
Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), 1038-1046. https://onlinelibrary.wiley.com/doi/abs/10.1111/scs.12546
Izadpanah, F., Nikfar, S., Imcheh, F. B., Amini, M., & Zargaran, M. (2018). Assessment of frequency and causes of medication errors in paediatrics and emergency wards of teaching hospitals affiliated with Tehran University of Medical Sciences (24 Hospitals). Journal of medicine and life, 11(4), 299. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6418340/
Piroozi, B., Mohamadi-Bolbanabad, A., Safari, H., Amerzadeh, M., Moradi, G., Usefi, D., … & Gray, S. (2019). Frequency and potential causes of medication errors from nurses’ viewpoint in hospitals affiliated with a medical sciences university in Iran. International Journal of human rights in healthcare. https://www.emerald.com/insight/content/doi/10.1108/IJHRH-11-2018-0072/full/html?casa_token=k3wKPIY60ioAAAAA:ibKQRNpCOTFzuY3mWLkZl8Wiza0MSEXxUGFvIaf010FO6OVPIQbcUkKOMm9a-AKcYysig_F7GG8dhomTd27r3IzqHJA7lc4xdr6X0OtNTAABRUDsuVRQ
SHoHani, M., & Tavan, H. (2018). Factors affecting medication errors from the perspective of nursing staff. J Clin Diagn Res, 12(3). https://www.researchgate.net/profile/Masoumeh-Shohani/publication/324405979_Factors_Affecting_Medication_Errors_from_the_Perspective_of_Nursing_Staff/links/5af587dea6fdcc0c030bb2e3/Factors-Affecting-Medication-Errors-from-the-Perspective-of-Nursing-Staff.pdf
Zarea, K., Mohammadi, A., Beiranvand, S., Hassani, F., & Baraz, S. (2018). Iranian nurses’
medication errors: A survey of the types, the causes, and the related factors. International journal of Africa nursing sciences, 8, 112-116. https://www.sciencedirect.com/science/article/pii/S2214139117300811