Journal Critique on Nurses' Perspectives and Experiences on Medication Safety Practices

This journal critique analyzes nurses' perspectives and experiences on medication safety practices. The study reveals the importance of medical safety and the role of nurses in medication safety. The article also highlights the factors that affect nurses' capability to deliver work safely and the measures that can be implemented to enhance medical safety.

Running head: JOURNAL CRITIQUE 1
Journal Critique
Student’s Name
Institutional Affiliation

JOURNAL CRITIQUE 2
Journal Critique
1. Introduction
Maintenance of medical safety is vital. It ensures that patients receive quality, safe,
timely and patient-centered medication. Although medical errors are inevitable, they ought to be
avoided. Typically, medical errors result in adverse health effects and unnecessary additional
medical expenses (Pham et al, 2012). Therefore, medical errors entail any avertable conditions
which could result in irrelevant medication or subsequent patient harm. Medical errors are
approximated to be less than a quarter of all the administered medications. A third of these errors
result to harm on patients (Starmer et al, 2014). Medical administrative errors occur when the
standard norms of clinical administration are breached (Garrouste-Orgeas et al, 2012). They
include the right drug, patient, dose, route, time, documentation and reason.
2. Research problem and importance.
The research problem of this study is quite relevant and helpful. Conventionally, there
exists scanty data concerning the perspectives and experiences of medical practitioners. In
addition, this is in regards to the effective application of safety procedures and avoidance of
medical errors (Senders, 2018). Knowledge concerning these perspectives and experiences will
be imperative in establishing applicable safety processes and their implementation (David et al,
2013). Therefore, the significance of this research is to provide an in-depth analysis regarding
medical experts’ perspectives and encounters so as to steer clear medical errors.
3. Research design and methods.
According to the article, the research design is suitable. The authors have justified the
method utilized in the study. The research was conducted in a university hospital. Each
medication is stored and administration prepared by medical experts mostly nurses. An

JOURNAL CRITIQUE 3
electronic prescription system is utilized by physicians in prescribing medication. Any drug
administrations and prescriptions that are done have to be recorded. Every nurse handles specific
patients to ensure easy monitoring of progress.
The research design also explains how participants were incorporated into the study. A
qualitative investigative research was conducted in nurses. Subsequently, this aimed at obtaining
a comprehensive perspective concerning the operational and management levels. Purposive
sampling designed to getting a greater heterogeneity was used. Foremost, the safety and quality
innovators of nurse managers were requested to contribute to the study. Snowball sampling was
utilized to retrieve the names of nurses in other departments who represent different levels of
seniority and training (Smeulers et al, 2014). In the same token, only registered nurses were
incorporated into the study.
Data collection was done through predetermined interviews. The interviews provided a
wider scope for nurses to express themselves. They could also seek any guidance from the
interviewers. All participants were requested to reflect on the essence of safety practices before
the research was concluded.
The research design observed ethics since the interview process was comprehensively
explained to the participants. Formal written consent was obtained from each person who
participated. Interviews were recorded for future reference and analysis, for instance,
transcription (Smeulers et al, 2014). Consequently, analysis of data was done simultaneously
with the interviews. All interviews were coded separately at the end of each interview. Codes
were interpreted, discussed and compared. In addition, reviewing was performed and conclusions
made. The most applicable themes were identified which relate to nurses perspectives and

JOURNAL CRITIQUE 4
experiences. Furthermore, the classification of themes was achieved through consensus.
Eventually, analysis of the identified themes was performed and verified.
4. Findings and their importance
Generally, only three particular themes were identified from the study. They were nurses’
responsibilities and roles in medical safety, their capability to safely work in their daily routine
and their acceptance to safety practices.
The medical experts interviewed felt accountable and responsible for the safe preparation
and administration of medication (Smeulers et al, 2014). Likewise, they perceived that they have
a continuing obligation of assessing patient’s medical conditions in regards to the prescribed
medications. They emphasized on the need to be alert and work keenly when dealing with
medication. Other nurses stated that this responsibility made them feel vulnerable as they are
individually accountable for any medical errors they cause.
The article reveals that nurses have an essential role. They are useful in the general
medication process and subsequently in medication safety (Smeulers et al, 2014). Clinical
reasoning is expected of any nurse even though the physician prescribes the medication.
Checking the prescribed medication comprehensively and examining the actual patient situation
is fundamental.
A nurse’s capability to deliver work safely in regards to medication is affected by various
factors. One of them is the consciousness of an imminent error and conditions of work. The
cognizance of the possibility of potential medical errors is different among different nurses.
Basically, nurses obtain their awareness from previous knowledge on incident reports, aftermaths
of errors and personal experiences (Makary and Daniel, 2016). On the other hand, other nurses
reveal that medical errors are as a result of insufficient experience and knowledge.

JOURNAL CRITIQUE 5
The study reveals that if an unfortunate incidence occurs, extra awareness programs are
established to enlighten the medical professionals. Additionally, these programs necessitate
urgent measures to make sure there is an improvement of the work conditions. Various
circumstances contribute to errors which might arise in the course of work. The dependency on
others, work environment, and work pressure are some of the key factors which cause medical
errors. Increased work pressure makes nurses multitask. Similarly, this results in minimal
concentration hence hurried work. In such cases, therefore, if the potential mistake will not affect
patients much, then nurses may forego the established safety procedures.
Subsequently, medical experts ought to mitigate work pressure to make sure quality
healthcare services are provided. Nurses have to apply personalized efficiency practices. For
instance, early preparation on how to handle different patients that one is assigned. Medical
safety is influenced by the environment in which health experts prepare medication. Often, it is
disturbing when nurses enter the medication room simultaneously (Andel et al, 2012).
Concentration and tranquility are lost hence the possible emergence of medical errors.
To enhance improvement of medical safety several measures have to be implemented. It
is imperative to acknowledge the pivotal role of medical experts. Subsequently, this is because
they strive to provide the finest care. The way in which care is delivered should be considered.
Healthcare ought to be availed in the most professional manner possible to evade minor errors.
Nurse-associated factors, for example, education, transformational leadership, relationship with
colleagues and staffing concerns must be considered hence improved to reduce medical errors
(Van Cott, 2018). Furthermore, the practice environment should be supportive of the provision of
safe care. Excellent management at work will also make nurses initiate mechanisms which
identify errors hence evade them.

JOURNAL CRITIQUE 6
5. Conclusion
Striving to maintain a medical free error environment is paramount as it ensures patient
welfare is upheld. The way to mitigate error is to learn and identify the causes of error and utilize
knowledge to establish mechanisms for reducing it (Topol and Hill, 2012). Consequently, in the
process, policymakers, researchers, and medical stakeholders have increased their efforts to
comprehend and transform institutional conditions and components that cause medical errors.
Medical procedures are subject to errors because there exist numerous environmental and
workload concerns experienced by nurses. On the contrary, nurses have the ability to recognize,
interpret and correct errors in advance before they have negative effects on patients. There are
several practices which have come up to aid in reducing clinical mistakes. They include
medication education, e-learning, electronic systems, interruption protection, double checking,
visual reminders, and protocols. Having dedicated medical professional is significant in steering
clear minor errors.

JOURNAL CRITIQUE 7
References
Andel, C., Davidow, S. L., Hollander, M., & Moreno, D. A. (2012). The economics of health
care quality and medical errors. Journal of health care finance, 39(1), 39.
David, G., Gunnarsson, C. L., Waters, H. C., Horblyuk, R., & Kaplan, H. S. (2013). Economic
measurement of medical errors using a hospital claims database. Value in Health, 16(2),
305-310.
Garrouste-Orgeas, M., Philippart, F., Bruel, C., Max, A., Lau, N., & Misset, B. (2012). Overview
of medical errors and adverse events. Annals of intensive care, 2(1), 2.
Makary, M. A., & Daniel, M. (2016). Medical error-the third leading cause of death in the
US. BMJ: British Medical Journal (Online), 353.
Pham, J. C., Aswani, M. S., Rosen, M., Lee, H., Huddle, M., Weeks, K., & Pronovost, P. J.
(2012). Reducing medical errors and adverse events. Annual review of medicine, 63, 447-
463.
Senders, J. W. (2018). Medical devices, medical errors, and medical accidents. In Human error
in medicine (pp. 159-177). CRC Press.
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.
Starmer, A. J., Spector, N. D., Srivastava, R., West, D. C., Rosenbluth, G., Allen, A. D., ... &
Lipsitz, S. R. (2014). Changes in medical errors after implementation of a handoff
program. New England Journal of Medicine, 371(19), 1803-1812.
Topol, E. J., & Hill, D. (2012). The creative destruction of medicine: How the digital revolution
will create better health care (p. 2). New York: Basic Books.

JOURNAL CRITIQUE 8
Van Cott, H. (2018). Human errors: Their causes and reduction. In Human error in medicine (pp.
53-65). CRC Press.