Medication Safety: Qualitative and Quantitative Study

This article discusses a qualitative and quantitative study on medication safety, exploring the aim, significance, methods, data analysis, results, limitations, and recommendations. The study utilized a semi-structured interview method and analyzed the collected data using MAXQDA10 software and SPSS version-20. The results identified three themes related to nurses' roles and responsibilities in medication safety, their ability to work safely, and acceptance of safety practices. The study recommends further research on the extensive roles of nurses with managers and the involvement of physicians and pharmacists in medication safety.

Medication safety
Medication Safety
Guided Question Qualitative Study Quantitative Study
1. Aim and Significance
a. What was the aim and
significance of the study?
According to Polit (2016), the value of the
research study can be determined by the
presence of clearly as well as unambiguously
stated aims, objectives and hypothesis as too
many research aims/questions can portray that
too much is studied. In this study, Smeulers
(2014) has identified and constructed a clear,
concise and achievable aim as ‘to explore the
experiences as well as perspectives of Nurses
on preventing the medication administration
errors’.
The review of literature provides the foundation
for the significance of study as well as
The objectives/aims are the specific
accomplishments developed by the study-
researchers to achieve what they have
indented to inquire (Polit, 2016). In this study,
the researchers have given a clear
objective/aim as ‘to investigate the association
between the workplace supports and
relationships and safe medication practices
among Australian graduate nurses’ (Sahay,
2015). Their aim is concise, appropriate as
well as achievable and also helps them to
solve their research problem, as advised by
Iverson (2014).
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relationship to practice. (Boswell, 2015).
The study’s significance is that appropriate
insight into nurses’ experiences as well as
perspectives on controlling medication
administration errors highly is important and can
also be used in tailoring & implementing safety
practices and hence they have proposed this
study to learn about the experiences and
perspectives of nurses in preventing MAEs..
The significance include despite of the
growing awareness about the positive
workplace supports and relationships,
unsupportive as well as disruptive workplace
behaviors are widespread in Health-care
organizations. More particularly teh recent
graduate nurses are new to workplace, and
are vulnerable in unsupportive environments
and with higher risk for medication error. This
has motivated the researchers to conduct this
study to investigate the effect of workplace
supports and relations on safe medication
practices. .
2. Methods
a. Identify the
research design used
The researchers have used qualitative
exploratory design to obtain broad perspectives
Sahay (2015).has used survey-based
exploratory & descriptive research design to
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in the study and was
it appropriate for the
issue discussed?
on preventing medication administration errors
(MAEs). Basically, Qualitative research is a
sequential, interactive and subjective research
design that is employed to clearly understand the
underlying reasons, facts, opinions, ideas and
motivations and describe the personal
experiences of individuals by giving them
meaning (Yin, 2015, Merriam,, 2916). According
to Polit (2016), qualitative design is utilized to
describe and promote the understanding of
individual experiences such as pain, disabilities &
difficulties (Grossoehme, 2013). In addition to
that, it explores the selected human experience
in an in-depth manner by gathering a rich
narrative qualitative data (Grove, 2015).
Smeulers (2014) has used a qualitative research
explore the influence of workplace supports
and relationships on safe medication
practices. They performed descriptive
quantitative study of a larger sequential mixed
methods study. They have mentioned that
little information regarding influence of
workplace supports as well as relationships
and safe medication errors, and several
variables requiring newly developed measures
has motivated them to adopt survey-based
exploratory & descriptive design which is
adequate (Curtis, 2013)..This research-design
has provided the chance to refine new
measures and enable understandings of their
variables. MOrover, Quantitative design is
considered superior to other types as they
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design to deeply explore the experiences with
and perspectives of nurses on preventing MAEs
by utilizing semi- structured interview method.
This proves that the selected qualitative design
can help them to deeply explore what they have
intended to achieve based on their subject, here,
MAES to draw solutions, which is highly
appropriate.
study teh cause and effect of a particular
issue (Henly, 2016). Hence the selected
design can address the medication errors and
can explore the effect of workplace supports
and relationships on safe medication
practices.
b. Discuss the sampling
technique, inclusion and
exclusion criteria used for the
selection of sample in the
study
The researchers have utilized purposive or
judgmental sampling technique to elicit a broad
perspective on the subject from the managerial
and the operational level nurses. It is a non-
probability sampling technique in which the
participants were selected based on the personal
judgment (voluntarily) of the study-researchers
about which one’s will be more informative
They have adopted convenience sampling
technique with 58 nursing graduates in 2
Australian States. Convenience/ accidental
sampling involve selection of most readily
available subjects for teh study (LoBiondo-
Wood, 2014). .This technique may subject to
bias as it selects the only the interested
persons. Eligibility criteria has to be identified
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(Grove, 2015). Smeulers (2014) has purposely
recruited samples by judging them as the typical
of the target- population with specific knowledge
about the study-problem which is appropriate.
The text suggests that two researchers have
approached the nurse managers, quality & safety
innovators, and nurse ward managers by e-mail
with requests to participate in the study on
practices to promote medication safety. The
researchers have also utilized Snowball sampling
to get the names of other staff-nurses from
varied departments, representing varied training
and seniority levels as well as differing attitudes
towards medication safety practices, as advised
by Polit (2016).
According to Polit (2016) eligibility criteria is
before beginning recruitment as appropriate
selection of inclusion & exclusion criteria can
enhance the external and internal validity of
the study-findings, promote the feasibility of
the study, provides un-biased study-findings
and minimize the study’s’ cost and ethical-
constraints (Yin, 2016). Polit (2016) suggested
that such recruitment can enhance the
homogeneity of the selected samples by
adequate control of confounders. They have
included only the recent graduate nurses
(registered within the first 18–24 months of
practice), which is appropriate.
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defined as the criteria that designate specific
characteristics of the target population by which
participants are recruited to participate in the
study. Selecting subjects within inclusion criteria
(characteristics that the samples should possess)
and the exclusion criteria (characteristics that the
subject should never possess) is highly
important, which is evidenced in this study. In
this study, the researchers have kept only one
eligibility criteria to be registered nurses, which is
adequate for this study based on their objective.
c.Explore the data collection
method and its
appropriateness to the
research design of the study
The researchers have gathered qualitative
(narrative) data to address the study problem
through a semi-structured individual interview
method (n= 20) from March to December 2011/
with each lasting 60–90 minutes. According to
Quantitative data-collection involves collection
of data in a numeric form (Grove, 2015). They
have recruited the samples through the
databases of recent nursing-graduates from 3
Australian universities with 1425 recent
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Medication safety
Polit (2016), semi-structured interviews allow the
subjects to ventilate freely with pre-structured
guidance from the interviewer using a list of
topics, which is evidenced in this study. Their
topic list with plan of changes in practice,
possible barriers & facilitators, characteristics of
the involved professionals and the societal and
organizational context is adequate.
Additionally, Qualitative research usually
associates with the naturalistic way of inquiry that
strives to study the issues of human complexities
by deeply exploring it (Panneerselvam, 2014). It
often aim to obtain a detailed with complete
description about the observed issues, including
the core context of the issues as well as the
evolved circumstances. Here, the researchers
nursing-graduates; 30% with active university
email accounts. They have opened the survey
link in emails on administrative-staffs at each
university (without direct involvement) and 58
has completed the survey. Though online
survey method is acceptable, large non-
responders, shows that they could have
improved their data collection method. .
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have utilized a semi-structured interview
technique to elicit the perspectives of nurses on
preventing MAEs.
3. Data analysis and results
a.How was the data analysed
and was it appropriate for the
study?
The researchers have performed data analysis
by organizing and interpreting the collected data.
They used MAXQDA10 software to code
interviews independently after each interview and
has compared codes and discussed until
consensus on coding tree was achieved. They
have drawn most relevant themes based on the
nurses’ experiences in & perspectives on
preventing MAEs and has sorted and analyzed.
Two co-authors have peer-reviewed the results.
Applicable data analysis methods have to be
used as it involves organizing and structuring
Sahay (2015).has downloaded the survey
data from the Qualtrics online-platform which
was posted on the University’s website &
analyzed through SPSS version-20. They
have run the descriptive statistics on the
complete set of information to note logical
graduate-responses and identify the extent of
missed data. They adopted frequency
distributions (mean and standard deviations)
and Spearman's correlation as given by Polit
(2016), which is highly appropriate for a
quantitative study.
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Medication safety
data, eliciting meaning to frame themes, and
frameworks (Polit, 2016), which is evident in this
study. .
b.What were the
findings/results of the study?
Smeulers (2014) has identified 3 themes: (1)
nurses’ roles and
responsibilities in medication safety: in-spite of
safe preparation and administration, their clinical
reasoning is crucial for medication safety; (2)
nurses’ ability to work safely: knowledge about
risks & nurse’s working environment influence
their ability to work safely; and (3) nurses’
acceptance of safety practices: feasibility,
appropriateness & advantages, are important for
acceptance of a safe practice.
The Spearman's correlations suggested that
un-supportive workplace relationships were
inversely related-to graduate-nurse
medication errors as well as destruction of
safe
medication practices, conversely supportive
Nurse Unit-Manager & work-team
relationships have positively influenced the
graduate-nurse’s safe medication practice
c.Discuss the limitations and
recommendations of the
The researchers have conducted this study only
in a single University setting and hence the
The authors have employed online survey
method through University emails to access
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study? results cannot be generalized. They have
recommended to conduct future research on
further investigation of the extensive roles of
nurses with managers with powerful incentives.
Physicians and pharmacists can provide a
broader perspective on nurse’s role in medication
safety.
the recent graduates which is a major
limitation as a considerable period of time had
elapsed since graduation. Moreover, use of
convenience sample, self-report, and lack of
information on non-responders can introduce
bias that questions the reliability of findings.
The sample size is small but is sufficient for
an exploratory study (Polit, 2016). It is
supported by Johanson and Brooks (2010)
that the samples greater than 50 is enough to
avoid bias in standard error estimates and 30
samples from a representative population of
interest is a minimal recommendation for an
exploratory survey.
The authors recommend that tese findings
can be tested through hypotheses by adopting
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a large scale study which could inform the
development of undergraduate and continuing
education programmes.
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References
Boswell, C & Cannon. (2017). Introduction to nursing research- Incorporating evidence based practice Retrieved from
https://books.google.co.in/books?id=nsQwCwAAQBAJ&pg=
PA312&dq=Polit+tools+in+research&hl=en&sa=X&ved=0ahUKEwj6xdOJmpHbAhUBKJQKHYLMBKQQ6AEIXzAJ#v=onepa
ge&q=Polit%20tools%20in%20research&f=fal
Curtis, E. A., & Drennan, J. (Eds.). (2013). Quantitative health research: Issues and methods. Maidenhead, United Kingdom: Open
University Press.
Gerrish, K., & Lathlean, J. (2015). The research process in nursing (7th ed.). Malden, MA: John Wiley & Sons.
Grossoehme, D.H et al. (2013). "I honestly believe God keeps me healthy so I can take care of my child: Parental use of faith
related to treatment adherence: Journal of Health Care Chaplaincy. 19(2):66–78. doi: 10.1080/08854726.2013.779540.
Grove, S. K., Grey, J. R., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice (6th ed.).
London, United Kingdom: Elsevier
Henly, S. J. (2016). Routledge international handbook of advanced quantitative methods in nursing research. New York, NY: Taylor
& Francis.
Iverson, K.M. (2014). Women veterans’ preferences for intimate partner violence screening and response procedures within the
Veterans Health Administration. Research in Nursing and Health, 37, 302-311
12

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Johanson, A.G & Brooks, P.G. (2010). Initial scale development: sample size for pilot studies, Educ. Psychol, 70 (3), 394–400.
LoBiondo-Wood, G & Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based. Retrieved from
https://books.google.co.in/books?isbn=0323100864
Merriam, S. B., &Tisdell, E. J. (2016). Qualitative research: A guide to design and implementation (4th ed.). San Francisco, CA:
Jossey-Bass.
Panneerselvam, R. (2014). Research Methodology. Retrieved from https://books.google.co.in/books?isbn=8120349466
Polit, D.F & Beck, C.T. (2016). Nursing Research: Generating and assessing evidence for nursing practice. Lippincott Williams &
Wilkins: New Delhi.
Sahay, A., Hutchinson, M., & East, L. (2016). Exploring the influence of workplace supports and relationships on safe medication
practice: A pilot study of Australian graduate nurses, Nurse Education Today, 35, e21-e26
Smeulers, M., Onderwater, A. T., Zwieten, M. C. B., & Vermeulen, H. (2014). Nurses' experiences and perspectives on medication
safety practices: an explorative qualitative study, Journal of Nursing Management, 22, 276-285
Yin, R.K. (2015). Qualitative Research from Start to Finish. Retrieved from https://books.google.co.in/books?isbn=1462521347
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