Preventing Medication Errors: Utilizing Evidence-Based Practice

This paper discusses the issue of medication errors and how to prevent them using evidence-based practice. It identifies the strong evidence that can prevent medication errors and the steps of the EBP process to do so.

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MEDICATION ERROR
Name of the student:
Name of the university:
Author note:

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Introduction:
Evidence based practice (EBP) is the approach to identify best practice evidence that
provides optimal care to patient and combine the evidence with clinical skills and patient values
to deliver care. The main purpose of the paper is to look into the issue of medication errors and
use the steps of the EBP process to identify the strong evidence that can prevent medication
errors (DiCenso, Guyatt & Ciliska, 2014). Medication error can be defined as the preventable
events that have the capability of causing or leading to inappropriate medication use affecting the
health of the patients (Salmasi et al., 2015). Occurrence of these events may be due to
professional practices or healthcare products, different types of procedures as well as systems
that might include improper prescribing, order communication as well as product labeling. The
paper looks at the consequence of medication errors and ways to prevent it in practice setting
using the EBP process.
Rational for medication error as a practice issue:
The medication errors have threatening effects on the health of the patient and the family
members. It results in preventable deaths, long stays in the hospitals, readmissions of the
patients, poor quality health of the patient and suffering. It also leads to loss of trust and respect
among the healthcare members and the patients that also affect the reputation of the healthcare
sectors and overflow of healthcare resources. Nanji et al. (2016) had stated that it also has
negative impacts on the professionals where they suffer from feelings of guilt and fear about the
events. They fear of losing their license that would affect their career. They also feel guilty of
making the patients suffer more that affect their morale as well as their self-confidence. They get

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involved in different types of legal obligations that affect the career of the professionals and the
brand reputation of the healthcare center (Parry, Barribal & While, 2015).
Preventing medication errors following the steps of the EBP process:
To prevent medication errors and promote patient safety, identifying the best
interventions that can prevent medication is critical. The six steps of the EBP process can guide
in identifying the best evidence to prevent medication errors. These are as follows:
1. Development of clinical question:
The first step a to search for strongest evidence related to practice issue according to the EBP
process is to frame a clinically guiding research question that can help to retrieve relevant
research literatures on the topic. PICO question can provide a pathway to search for relevant
evidence (Hall & Roussel, 2016). The PICO question related to medication error prevention
includes the following:
Is computerized medication order entry (intervention) effective in preventing medication
errors (outcome) in medicine ward (population)?
2. Retrieving evidence from the right source:
Several medical and health care databases like Medline, CINAHL and PubMed can help to
search for best evidence that prevent medication errors in clinical setting. Use of keywords from
the clinical question helps to proceed with the search for relevant research literatures (Hall &
Roussel, 2016). The search terms that can be used for the above clinical question includes
computerized medication order entry, medication errors or medicine, medication error prevention
and reducing medication errors. The search term helped to retrieve various interventions that has
been implemented to reduce medication errors.

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3. Critical evaluation of the selected evidence:
The review of research evidence revealed CPOE as an effective intervention to prevent
medication errors. This could be identified by the analysis of research outcome and determining
the credibility, validity and reliability of the research evidence. The articles that gave idea about
the effectiveness of CPOE included the study by Slight et al. (2015). Slight et al. (2015)
evaluated the impact of CPOE by prospective time series analysis and medication errors related
outcome was evaluated before and after the implementation of the intervention. The study
findings revealed significant reduction in non-missed-dose medication errors and reduction was
found in both intensive and general care units. The reliability of the evidence was confirmed by
the review of validated tools to collect data and characteristics of the CPOE system. The
strength of the data collection process was that type of medication errors was clearly defined and
the medication error was detected by means of drug dispensing and administration analysis to
promote transparency. To confirm the validity of the research evidence, other articles related to
CPOE outcome was analyzed. The finding of the study was found to be consistent with the
research by Radley et al. (2013) as that study also confirmed that CPOE can significantly reduce
frequency of medication errors in acute-care setting.
4. Integration of research evidence with client value clinical skills
As the critical appraisal of research evidence and comparison with other research articles
confirmed use of CPOE as an effective intervention to reduce medication errors, the next step
was to assess whether the intervention can be applied with current clinical expertise. To support
nurses to use CPOE in medicine wards, providing them training in efficient use of the system is
necessary. In addition, as per patient’s values, it will be essential to protect the confidentiality of
patient’s information while recording medication related allergies.

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5. Reflection and analysis of outcome:
To evaluate whether CPOE can prevent medication error in the medicine ward, the strategy
that can be employed by nursing staff is to record medication error rate before and after using
CPOE. This may to evaluate the success of the intervention.
6. Dissemination of the evidence:
If desired results are obtained, then the utility of the intervention can be communicated to
other clinical team members and staffs in the medicine (Hall & Roussel, 2016).
Conclusion:
From the above discussion, it becomes clear that medication error is one of the most
threatening events that not only affects the quality of life of the patents but also affects the the
reputation of healthcare centers. The discussion regarding the utilization of the steps of the EBP
process to identify the best practice evidence to prevent medication errors defines the importance
of EBP in promoting practice improvement. The discussion proves use of CPOE as an effective
step to reduce medication error related events and promote safety of patients in clinical settings.

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References:
DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to
Clinical Practice. Elsevier Health Sciences.
Hall, H. R., & Roussel, L. A. (2016). Evidence-based practice. Jones & Bartlett Publishers.
Slight, S. P., Eguale, T., Amato, M. G., Seger, A. C., Whitney, D. L., Bates, D. W., & Schiff, G.
D. (2015). The vulnerabilities of computerized physician order entry systems: a
qualitative study. Journal of the American Medical Informatics Association, 23(2), 311-
316.
Radley, D. C., Wasserman, M. R., Olsho, L. E., Shoemaker, S. J., Spranca, M. D., & Bradshaw,
B. (2013). Reduction in medication errors in hospitals due to adoption of computerized
provider order entry systems. Journal of the American Medical Informatics
Association, 20(3), 470-476.
Nanji, K. C., Patel, A., Shaikh, S., Seger, D. L., & Bates, D. W. (2016). Evaluation of
perioperative medication errors and adverse drug events. Anesthesiology: The Journal of
the American Society of Anesthesiologists, 124(1), 25-34.
Parry, A. M., Barriball, K. L., & While, A. E. (2015). Factors contributing to Registered Nurse
medication administration error: A narrative review. International journal of nursing
studies, 52(1), 403-420.
Salmasi, S., Khan, T. M., Hong, Y. H., Ming, L. C., & Wong, T. W. (2015). Medication errors in
the Southeast Asian countries: A systematic review. PLoS One, 10(9), e0136545.