Problem of Drug Errors and Elements of Evidence

Search Report Identifying Issues
And Searching For Evidence

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Identify an issue or situation from practice or in healthcare that requires an evidence informed
approach.................................................................................................................................3
Elements of evidence informed practice (EIP) triad and importance of understanding the issue
for a registered nurse..............................................................................................................4
Develop a searchable question using an appropriate framework...........................................6
Design a search strategy including database choice, key terms and Boolean operators........7
Evidence based resources to answer the clinical question.....................................................8
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Issues related to healthcare practices consist problems faced by care professionals while
conducting clinical procedures that impacts on patient outcomes. It includes various issues such
as lack of staff, additional work load, unavailability of resources and lack of technological
support that affects their performance and relevant outputs in healthcare (Aromataris and et. al,
2015). The present report will focus on problem of drug errors and elements of evidence
informed practice triad. It will also includes appropriate framework by using searchable question
and search strategy including data base choice, key terms as well as Boolean operators. The
identification of four sources to address the specific problem is given below.
MAIN BODY
Identify an issue or situation from practice or in healthcare that requires an evidence informed
approach
Clinical practices are very critical and required to be carried out carefully to achieve
desired patient outcomes. It is necessary for nursing staff to utilise proper criteria of conducting
treatment procedures for wellness of people. However, it has been analysed that lack of nursing

staff increase possibility of drug errors which are responsible for creating complex conditions for
patient (Roberts and et. al., 2014). Meanwhile, the drugs errors or other relevant mistakes may
develop complicate condition or may leads to death of an individual. In addition to this, drug
errors become a major problem among registered nurses because additional work load faced by
them. It is required to manage work pressure for reducing the possibility of this problem in
health care sector. However, it is necessary to focus on the issue of drug errors and establish
effective strategies or methods to overcome the same in proper manner (Brownson and et. al,
2017). Moreover, it is essential to manage work pressure in such a way so that nursing staff can
gain proper rest between working shifts which impacts positively on their performance along
with decreasing medication mistakes.
At the other hand, the problem of drug errors requires evidence informed approach to
apply the same in order to gain desired outcomes. It consist the fact that evidenced based
practices can be implemented with surety because investigators have already researched about it
along with ensuring its benefits to decrease medication mistakes in health care (Burton,
Brundrett and Jones, 2014). However, it is required for nursing staff to apply evidence informed
practices because they have less chances of occurring risks. Such clinical procedures with
evidences are favourable to increase effectiveness of performance along with improving medical
condition of sick people. It is necessary for care professionals to focus on evidence based
approach because it is effective to manage extra work pressure. It is also helpful in regards to
improve quality of care services which are delivered to patients for their well-being (Ban,
Graham and Connolly, 2014). Moreover, it is helpful to decrease costs of healthcare services
along with reducing geographic variations in context of delivering care facilities. Additionally, it
is also favourable to decrease care professionals turnover rate which reduce work pressure and
drug errors as well (Dang and Dearholt, 2017).
Elements of evidence informed practice (EIP) triad and importance of understanding the issue
for a registered nurse
Evidence informed approach can be described as an integration of best research evidence
with clinical expertise and patient values. It can be implemented by care professionals that will
ultimately leads to improved patient outcomes (Noble, 2018). Basically, it consist number of
fundamental elements such as client perspectives, clinical expertise and scientific evidence that
combines to establish model of evidence based practice.

(Source: Evidence-Based Practice (EBP), 2019)
Initially, the components of best evidence includes an effective investigation relevant to
clinical practices through utilisation of an appropriate methodology of sound. It is effective
techniques to decrease possibilities of medication mistakes. Best evidence can be described as a
rule evidence which needs an original of writing, recording or photographs to prove its relevant
data. Best evidence is helpful to make EBP more effective which is favourable for strengthening
values and beliefs through which they can establish appropriate decision of treatment. However,
clinical expertise is known as the second elements that can be described as certain aspects related
to clinicians such as experience, clinical abilities & skills and cumulated education (Boyle and et.
al., 2016). It is helpful to enhance expertise of care professionals which helps to reduce chance of
occurring drug errors. In addition to this, the third components is patient values or perspectives
that are unique in different cases of patients in which they have their unique concerns,
expectations and preferences brings to a clinical encounter accordingly. It will facilitate to avoid
drug errors and complications in patient condition by increase comfort level of them. Moreover,
these factor are responsible for integrating themselves which describe about evidence based
Illustration 1: Evidence-Based Practice (EBP)

clinical decision which is much efficient to improve patients outcomes respectively (HaßLER,
Major and Hennessy, 2016).
At the other hand, it has been analysed that integration of these important components is
required to be conduct effectively with the help of following number of steps mentioned here.
Firstly, it includes the formulation of an answerable question which requires specific
fundamental skills and then focus on actual matter relevant to the same (Grove, Gray and Faan,
2019). This question should be relevant to different patient aspects such as diagnosis, prognosis,
therapy and aetiology. Secondly, it consist the criterion of finding the best evidence available
related to the formulated question by investing in proper way. It includes fact that utilisation of
PubMed and Cochrane library should be consider in order to prepare effective search strategy by
using a combination of MESH terms and limitations of outcomes. Thirdly, it involves appraising
the evidence by investing various studies and filtering them and use of simple critical appraisal
methods (McGowan and et. al, 2016). However, implementation of the EBP through which
clinical decision should be made in regards to provide correct care services for wellness of
patient. It consist the utilisation of combination of best evidences available with clinical expertise
as well as perspectives of patient. Moreover, final step includes evaluation of the outcome in
which efficacy and effectiveness of decision can be evaluate in direct to related to particular
patient.
The issue of drug errors is important to be understand by nursing staff in order to solve it
because it impacts negatively on their performance as well as patient outcomes. It includes to
focus on various cause of drug error risk including lack of nursing staff and limited technological
support which create problem of employees to perform in effective manner (Leyden, Moss and
MacMathuna, 2014). The advanced technological support is helpful to share patient information
accurately which is suitable for reducing drug errors. Data can be easily transferred and restore
automatically but limited technology increase work of professionals that impact negatively on
their performance. Moreover, evidence informed approach can be used by considering three
significant elements for solving the issue of drug errors which facilitate to increase patient
outputs.
Develop a searchable question using an appropriate framework
PICO framework can be described as a mnemonic that is utilised in evidenced based
practice in order to frame along with answering a health related or clinical question. PICO stands

for population, intervention, comparison and outcome (Peters and et. al, 2015). Population
consist the selected group of individuals related the problem of drug errors i.e. nursing staff.
Intervention includes the best strategy to solve issues of drug errors. Comparison refers to
comparative strategy of chosen intervention for reducing medication errors whereas outcome
includes the respective results after implementation of selected strategy to decrease drug errors.
PICO Question – What is the possibility of drug errors due to lack of nursing staff which reduce
patient outcomes?
P: Population Medication errors by nursing staff.
I: Intervention Use health information system (HIS).
C: Comparison Effective training and learning.
O: Outcome Drug errors get reduced.
Design a search strategy including database choice, key terms and Boolean operators
Search strategy can be described as an organised structured of several key terms that can
be utilised for searching particular database. It is responsible for establishing combination of key
concepts related to specific search question in respect of retrieving an accurate outputs
(Rasmussen and et. al, 2016). However, it is helpful to investigate about specific questions in
order to address it with highly accurate information collected from relevant articles.
Database choice – There are various database that can be used from which relevant
information is collected that includes articles, journals and books available online. It consist
different websites in which few of them are were used in this study such as minoritynurse,
medcomrn, nursingcenter, onlinelibrary, fda, pharmaceutical-journal, healthcareitnews and so on.
However, these articles and journals are helpful to address the selected question regarding drug
errors and reduced patients outcomes due to lack of nursing staff (Bodziak, 2017).
Search strategy – The online articles are used to determine ways of solving problem of
drug errors for improving patient outcomes with the help of managing work of nursing staff. It
involves analysis of data in different articles to identify effective methods as well as techniques
which provide support to manage extra work load of nurses for reducing risk of occurring
medication mistakes (Lyons and Kuron, 2014). Meanwhile, it is observed that various methods

and practices are mentioned in the gathered data in which more suitable techniques should be
considered for solving problem of limited nursing staff to decrease drug errors.
Database Search terms Results
CINAHL Nursing staff OR Client
experience
56 articles
PubMed Drug errors AND patient
outcomes
7 articles
The above mentioned data base are used in this study because they have more relevant
and accurate information which is favourable to understand ways to reduce drug errors. It is
helpful to provide the effective strategies and methods which are suitable for managing
additional work pressure of nursing staff.
Inclusion and exclusion criteria – The inclusion criterion for analysing various articles
consist to utilise recent content which is related to specific question of reducing drug errors. It
has been applied by searching data in recent article published in last ten years in terms of
avoiding inaccuracy of outcomes. It also consist the standard of searching data includes to focus
on medication mistakes that are made by nursing staff only for identifying appropriate solving
techniques accordingly. At the other hand, exclusion criterion is to avoid past articles or studies
which are not applicable in the given context of reducing nursing drug errors properly (Straus
and et. al, 2018). However, it includes to avoid techniques of other care professionals and only
focus on methods to sort out issue of drug errors attempt by registered nurse in healthcare
organisations. The online articles before the year of 2000 were avoided for gathering relevant
data to conduct the investigation appropriately.
Evidence based resources to answer the clinical question
The research articles are selected on he basis of effective technique or methods which are
helpful to solve problem of drug errors by nursing staff. It is necessary for nursing leaders and
management of healthcare organisation to focus on this aspects in order to establishing effective
strategies and policies for increasing regular outcomes of performance of nurses (Wellington,
2015). However, it has been analysed that selected four articles provide specific techniques that
can be used for reducing chance of occurring medication mistakes.
Journal article 1: Investigating the Causes of Medication Errors and Strategies to Prevention of
Them from Nurses and Nursing Student Viewpoint

The study is based on purpose of investigating causes of medication errors and strategies
in order to prevent of them from nurses and nursing student view point. It can be considered as a
cross-sectional descriptive study that was carried out among 327 staff of a hospital and 62 intern
nursing students. However, it has been analysed that medical errors occur commonly due to
tiredness of excess workload and drug calculation by nursing students (Gorgich, 2015).
Moreover, this problem can be solved by reducing work pressure through increasing personnel in
desired proportion. Meanwhile, it is essential to maintain work load for reducing drug errors and
improve patient outcomes.
Journal article 2: Impact of Psychosocial Factors on Occurrence of Medication Errors among
Tehran Public Hospitals Nurses by Evaluating the Balance between Effort and Reward
This article is based on necessity of identifying and prevent factors influencing
medication errors by investigating the impact of psychological elements on nurses. It is a kind of
systematic review that was conducted on Medline connecting the terms of like patient
simulation, medication errors and simulation healthcare by excluding technology based
simulation reports to focus on human simulation in non-technical skills learning (Zaree, 2019).
However, the cross-sectional study was carried out considering population of 379 individuals. It
has been evaluated that most frequent errors are wrong dosage, drug and patient which are
required to be investigated for solving them by making effective strategies through hospital
management.
Journal article 3: Using information technology to reduce rates of medication errors in hospitals
This journal is based on utilisation of information technology in order to reduce rate of
medication errors. It is a meta analysis in order to determine about incidents related to adverse
drug reactions in hospitals for preventing them. Basically, it consist number of technological
systems or methods which are helpful to reduce the chance of occurring medication mistakes.
However, it has been analysed that several technical aspects are supportive such as computerised
physician decision support, robots for filling prescriptions, bar coding, automated dispensing
devices, computerised of medication administration records and computerised physician order
entry (Bates, 2000). These technological practices can be implemented in healthcare organisation
for eliminating the threat of drug errors in terms of improving patient outcomes.
Journal article 4: The role of health information technology in reducing preventable medical
errors and improving patient safety

This article is a kind of systematic review to analyse effective information technology
which can prevent problem of drug errors in healthcare organisations. It includes one of most
recent developments in health regarding information and communication technology in this
industry. Meanwhile, this investigation was carried out by utilising resources of library, websites,
search engines and manually search (Ehteshami, 2013). However, it has been analysed that
implementation of appropriate technology is helpful to boost up perfection in work of medical
staff which facilitate to reduce chance of occurring medication mistakes. Moreover, it is
observed that technological aspects are favourable to improve patient safety and increase abilities
of health practitioners to deal with people properly.
Journal article 5: Human‐simulation‐based learning to prevent medication error: A systematic
review
This journal article is based on improving skills, attitudes and knowledge in nurse,
prescribers & pharmaceutical staff by providing training to them. It includes utilisation of best
practice for simulation for healthcare providers should be analysed and implement accordingly.
It is a systematic review that was conducted on Medline linked with number of terms such as
Simulation healthcare, medication problems and patient simulation (Sarfati, 2019). However, it
is necessary to focus on communication skills of professionals and other threats of their abilities
to providing effective training or learning in term of eliminating the issue of drug errors in
hospitals for improving patient outputs.
CONCLUSION
From the above report, it has been analysed that drug errors refers to mistakes occurring
at the time of providing medication to someone. It includes to focus on specific search strategies
for analysing various relevant articles or websites like minoritynurse, medcomrn, nursingcenter,
onlinelibrary and many more. The technological support and training sessions are beneficial for
nursing staff in terms of decreasing chance of occurring drug errors along with improving patient
outcomes.

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