Critical Appraisal of an Article on Medication Safety Practices

This paper is a critical appraisal of the article - Smeulers, M., Onderwater, A. T., Zwieten, M. C., & Vermeulen, H. (2014). Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study. The study meant to explore the experiences and perspectives of nurses on medication safety practices. The paper discusses the research problem, research design and methods, findings and their relevance, and the conclusion. The study determined that nurses have a pivotal role to play on preventing medication errors.

Running head: CRITICAL APPRAISAL 1
Critical Appraisal of an Article
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Critical Appraisal
Introduction
Nurses assume a crucial part during the time spent pharmaceutical administration. They
partake in recognizing issues identified with medicine management in clinical practices. Drug
mistakes are a typical factor influencing the health of patients. Keeping in mind the end goal to
eliminate pharmaceutical mistakes we consider interdisciplinary correspondence and
multidisciplinary approach. 33% of prescription mistakes emerge amid administration of drug.
At the point when the seven R's which incorporate, right time, right medication, right dose, right
documentation, right course, right patient, and right reason are not clung to, MAE's are probably
going to happen.
This paper is a critical appraisal of the article - Smeulers, M., Onderwater, A. T.,
Zwieten, M. C., & Vermeulen, H. (2014). Nurses' experiences and perspectives on medication
safety practices: an explorative qualitative study. Journal of nursing management, 22(3), 276-
285. This is a report of a qualitative field study with nurses. The study meant to explore the
experiences and perspectives of nurses on medication safety practices. It report explores deep
into the critical appraisal of the various aspects of the article and the methods used by the
authors.
The Research Problem and Its Significance
The study looked to explore the experiences that nurses have with the prevention of
medication administration errors and to have an understanding of their perspectives on the same.
The authors hypothesized that an insight into the experiences and perspectives of nurses on the
errors that occur during drug administration can help in tailoring and implementing safety
practices (Smeulers et al, 2014). Medication safety is an important emerging issue in healthcare.

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Many patient get complications of disease as a result of medication errors (Berdot et al, 2012).
Medication errors can include over-dosage, under-dosage, administering the wrong medication,
giving medication to the wrong patients, inappropriate combination of medications, and
improper routes of administering medication (Bryman, 2017). Among the most important
complications of medication are prolonged hospital stay, increased rate of drug toxicities,
inadvertent physical injury, and death. Furthermore, nurses bear the primary responsibility of
drug administration hence their close involvement in this study (Irvine, Drew, & Sainsbury,
2013). Considering the magnitude of the issue at hand and its relevance to the nursing profession
and current practice, it is important to conduct studies and determine ways of preventing drug
administration errors. Prevention of such errors is an important part of improved patient care and
there is need to collect clinical evidence of the same.
Research Design and Methods
The researchers conducted a qualitative study. They were interested in understanding the
experiences and perspectives of nurses hence the suitability of a qualitative rather than a
quantitative study (Smeulers et al., 2014). Of the five qualitative study designs, the authors
utilized grounded theory. Grounded theory was the best design here since their study.
Considering the size and nature of the targeted participants, the researchers could not use a
phenomenology, a narrative or a case study (Lewis, 2015). Moreover, an ethnography was
inappropriate since the kind of data that the researchers were collecting was not anthropologic in
nature (Petty et al., 2012).
The researchers used snowball sampling to identify 20 participants of the study (Smuelers
et al., 2014). Snowball sampling is, however, a major weakness of the study. Snowball sampling,
like any other non-probability sampling method is subject to bias from the author (Palinkas et al.,

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2015; Robinson, 2014). Even worse, the selection biased is worse as each of the selected
participants selects another participant of their choice. It is also hard to separate the study criteria
from the prejudices and assumptions of the researchers. Despite the technicalities of sampling,
the researchers used a good sample size of 20 (Smeulers et al., 2014). The researchers did not
consider the gender, age, or race of the participants while selecting them. However, considering
the width of the subject matter, they would have utilized a larger number of participants; with a
grounded theory, the researchers had an allowance of using up to 50 participants (Keers et al.,
2013)
The researchers collected data utilizing semi-structured face-to-face interviews. Semi-
structured interviews are the best for collection of qualitative data as they allow the researcher to
explore as many aspects of the subject matter as possible (Bryman, 2017). In addition,
conducting the interviews face-to-face allows the interviews to capture the feelings of the
interviewees and the value that they attach to the subject of discussion by capturing their
intonation (Irvine et al., 2013). The researchers coded the interviews to identify the major
thematic concerns in the interviews simultaneously with the interview process.
Findings and their Relevance
The study determined that nurses have a pivotal role to play on preventing medication
errors. Being the primary health workers that deal with drug administration and medication
reconstitution, nurses have a responsibility to prevent medication errors (Keers et al., 2013;
Nuckols, et al., 2014)). The study also appreciated the need for nurses to work safely. On this,
the study determined that the nurses’ knowledge of risk and their various work circumstances
influence their ability to work safely (Berdot et al., 2012). Nevertheless, that once nurses accept
safety practices, it will be easier for them to practice these practices. For nurses to accept the

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safety practices in accordance with hospital policy, the practices have to be advantageous for
their work, feasible, and appropriate (Lewis, 2015). The study also found that in as much as
nurses believe that their experience is most crucial to their ability to prevent medication errors, it
is their sufficient knowledge of medication administration that is most important to them.
Therefore, safe medication requires a professional and learning climate that can allow for further
development of professional nursing skills and knowledge (Palinkas et al, 2015). For this reason,
it is important for nurse managers to continue developing an environment that is stimulating and
can enable continuous learning. Further, nurse managers should emphasize on the need to
disseminate more knowledge about medication safety and for continuous teaching.
Conclusion
The issues of medication safety are important in nursing practice. Smeulers et al. (2014)
set an important precedence for the consideration of this issue in evidence-based nursing
practice. Using the findings of their research, nurse leaders can develop nurse units where
medication errors are minimal; all they need to do is stimulate continuous learning and set a good
professional climate. Condition around the healthcare ought to be free from interruptions to
guarantee nurses center around patients. Medications should be all around marked to keep away
from disarray and attendants punished in the event of any ponder errors that cost the safety of
patients.

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Smeulers, M., Onderwater, A. T., Zwieten, M. C., & Vermeulen, H. (2014). Nurses' experiences
and perspectives on medication safety practices: an explorative qualitative study.
Journal of nursing management, 22(3), 276-285. DOI: 10.1111/jonm.12225