Critical Appraisal of Strategies to Reduce Medication Error

Running head: CRITICAL APPRAISAL
CRITICAL APPRAISAL
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CRITICAL APPRAISAL1
Medication error is defined as the failure or catastrophe of the treatment procedure
which result in adverse effect or can harm the patient and their well-being (Parry, Barriball &
While, 2015). Different research were conducted that were used to evaluate the strategies that
can be used to reduce the medication error. The study will focus on the capability of the nurse
to successfully critique the research and adapt best practice to reduce the error (Maugham et
al., 2018).
This study will examine two research papers that have focused on the concept of
medication error and critique the articles by evaluating the trustworthiness and validity of the
article (Connelly, 2016). Lastly, the study will also highlight the relevant contribution of the
research article towards the management of the clinical issue.
The first article will highlight the consequence of electronic health record within the
healthcare setting to enhance the patient safety; a qualitative exploratory study, was
performed by the researcher to identify the benefit of implementing EHR. Hence, the primary
aim of the research was to “discover the consequence of Electronic Health Record (EHR) by
the nurses to enhance patient safety” (Tubaishat, 2019).
In this article, the researcher had adapted qualitative exploratory method by using the
semi-structured interview process with the staff nurses who were working in the hospital.
According to Kieft et al. (2018), exploratory method is best suited for understanding the
perspective of the nurse who are already working the hospital to improve the understanding
of medication error and the individual experience of the nurses. Thematic analysis was
conducted for evaluating the experience shard by the nurse’s during their interview.
From the result, two primary themes were evaluated, where one theme focused on the
enhancements of patient safety due to EHR and the other theme focused on the issues
elevated due to the implementation of EHR. The result exhibited the advantage of

CRITICAL APPRAISAL2
implementing EHR and the advancement in reducing the clinical error and improving patient
safety (Tubaishat, 2019). Hence, it can be concluded that the issues associated with EHR was
majorly due to in-proper system use or the establishment of poor system that were hampering
patient safety. This research has successfully established that the nurse practising EHR can
facilitate the improvement of patient safety and reduce the rate of clinical error (Adelman et
al., 2019).
The qualitative research paper is assessed by using the theory of validity namely;
internal validity, external validity and measurement validity. According to Huebschmann,
Leavitt, & Glasgow (2019), internal and external validity is used in the research to identify
the trustworthiness and meaning of the study. Internal validity is used to relate how well the
study is executed and external validity is used to relate the applicability of the research
finding among the general population.
Internal validity is stated as the “procedural rigor” used by the researcher in the study
to evaluate the strategy used by the researcher to reduce the risk of biasness that might affect
the result of the study (Xu, Zhang & Zhou, 2019). This study has used diverse approaches to
strengthen the internal validity.
The researcher has included only one vendor of the EHR system in order to minimize
any risk of biasness, as the same system used by different nurses will help the researcher to
identify appropriate result (Tubaishat, 2019). A hand-out was made to explain all the
participating nurses regarding the aim of the research. Semi-structured interview was
performed to strengthen the internal validity associated with the implementation of probing
technique. This technique helped the researcher to collect an in-depth knowledge and
information of the response shared by each individual nurse (Tubaishat, 2019).

CRITICAL APPRAISAL3
Measurement validity was strengthen by using telephonic interview was conducted as
it was considered as an efficient method of collecting the qualitative data within the nursing
practice. The data was analysed thematically followed by five steps of Creswell and each
themes were cross-checked for minimising any risk of biasness. To strengthen the internal
validity, the trustworthiness was ensured by the researcher by using two different researcher.
The researchers had identified and compared the themes and to increase the reliability of the
study, they have also included citation that will precisely reflect on the perception of
individual nurses (Tubaishat, 2019).
Any type of disagreement was solved by the researcher and different sub-themes were
also identified on the basis of the experience and opinion of the individual nurse. The sub-
themes was used for strengthen the external validity as the identified themes were further
used to enhance the implementation of electronic Health Record (EHR) within daily practice
and patient safety (Tubaishat, 2019).
The second article will highlight the effect of implementing automated dispensing
cabinets (ADC) for medication selection associated with the preparation error in the
emergency department; prospective and direct observational study, was performed by the
researcher to identify the benefit or advantage of implementing automated dispensing
cabinets (ADC) (Burton, 2019). Hence, the primary aim of the study is to evaluate the effect
of automated dispensing cabinets (ADC) on preparation error rate and medication selection
within the emergency department located in the territory teaching hospital (Fanning, Jones &
Manias, 2016).
In this article, the researcher had adapted direct observational and prospective study
that was conducted before and after the intervention. Direct observation was performed for
the nurses completing the preparation and medication selection activities, after and before