University Research Comparison: Automated Dispensing Cabinets and EHRs

This report provides a comparative analysis of two research articles. The first article investigates the impact of automated dispensing cabinets (ADCs) on medication selection and preparation error rates within an emergency department setting. The second article explores the effects of electronic health records (EHRs) on patient safety, based on a qualitative exploratory study. The report summarizes the aims, methods, and findings of each study, including participant demographics, data collection procedures, and key results. It also discusses the validity, strengths, and limitations of each study, considering issues of internal, external, and measurement validity, as well as rigor and trustworthiness. A key aspect of the report is the comparison of the two papers, highlighting their contributions to clinical issues and patient safety. The analysis also includes the discussion of both studies' focus design and how they add to a clinical issue. The report concludes by synthesizing the insights from both studies to provide a comprehensive understanding of the current trends and challenges in healthcare research, particularly in the context of technological advancements and their impact on patient outcomes. References are included in the original document.

Running head: RESEARCH 1
Research: A comparison Between Two different Studies
Student’s name
University affiliation
Author’s note

RESEARCH 2
This article is a presentation of a summary of previously done works by researchers. The
main aim is to ensure that a student is able to read through other specialist's research and
summarize accordingly. In the process of summary, the first step is to list the aims and
hypotheses of the given articles. Then, an account of the methods used in the research, including
the participants, procedures, and materials used in the study. A summary of findings from the
research is also listed, and finally, the validity and strengths of both analyses listed (Kasmel, &
Tanggaard, 2011). A comparison between the two papers is also given through the various sub-
topics and how they can help in clinical issues. Articles provided are on impacts of automated
dispensing cabinets on medical section and preparation error rates in an emergency department,
and the effects of electronic health records on patient safety. The articles will be named one and
two, respectively, for this research.
Summary of the aims and hypothesis
In the first article, the main objective is to study how automated dispensing cabinets help
in the emergency departments within Australian hospitals. There have been numerous records on
the medical injuries occurring in the emergency departments, which facilitated this research. As
such, the main aim of the research was to investigate whether the automated dispensing cabinets
will help in selecting medical practices and also reduce preparation errors. The hypothesis for
this study was that there is a high rate in error for the pre-intervention studies.
On the other hand, the second article mentioned how electronic health records (EHRs)
have been on the rise. Apparently, they have brought more benefits to patients and improved
health care services (Kasmel, & Tanggaard, 2011). Mainly, the research was aimed at exploring
how the EHRs affect the safety of patients as alleged by the nurses. Comparing the two aims,
both have a common factor, which is enhancing the healthcare services. Both types of research

RESEARCH 3
aim to incorporate the current medical tools, which help nurses in emergency departments and
general areas within a healthcare organization.
Methods used in the research
In the first article, the research was done in Australia. Specifically, it was taken to the
Australian metropolitan teaching hospital, conducted in September 2014. During the study, there
was a pre-intervention and post-intervention study, which were done. The facility has 377-bed
tertiary teaching hospitals. Eighty-nine nurses were involved in completing the medication
activities across the new emergency departments, which were considered. During the post-
intervention, no new nurses were recruited. The first stage of data collection involved medication
details, dosage, strength, and form of the dose (Minkler, 2012). Also, details of patients were
recorded. In the second stage, the recorder medication details were compared to patients'
medication chart. Errors in form of discrepancies between the details collected and medication
chart were recorded too. Nurses were randomized during the whole process, and it was
convenient to undertake sampling. Data collection was taken from 7 am to midday. About 50
patients were observed on a daily basis taking roughly 3-4 hours.8 weeks after the ED, end-line
data commenced. As such, the primary materials used were the patient charts, which were
compared with medication details given to patients.
The second article used the qualitative exploratory study, which was based on semi-
structured surveys. The study was undertaken in Jordan. Here, there are numerous vendors for
the ERHs, which facilitated a smooth study. However, only one system was targeted, the
Hakeem Project. This is responsible for computerizing major healthcare systems, which are
found in Jordan, including military and public hospitals. Only one system was used to ensure
bias was reduced (Fanning, Jones, & Manias, 2016). At the same time, it provided detailed

RESEARCH 4
information about the system rather than having different system backgrounds (Soriano, 2013).
Based on the study, only 12 hospitals incorporated the Hakeem HER system. The materials used
included interview questions.
During the procedure, a flyer was designed to make all the nurses aware of what they are
involved in. The flyers had the research aim and procedure with the contact of the author. As
such, willing nurses were able to communicate directly to the author. The study included
volunteering participants to avoid getting the wrong information from the nurses. Sampling was
done to a point when saturation was achieved. Fifteen interviews were initially conducted, and
since data saturation was not met, two more interviews were added to make it 17 (Bofetta, 2010).
Participants were outsourced from different groups selected according to age and geographical
location. Some of the data collection materials included telephone interviews and field notes.
Since qualitative research in nursing research is better gathered using telephone interviews, it
was the most preferred tool for collecting data (Minkler, 2012). Despite taking field notes, there
were no audio recordings, which were taken. The interviews in this research lasted for 30 to 40
minutes, with an average of 36 minutes. The university lecturer was the principal researcher who
conducted the study.
Comparing the two studies, the second article had a variety of data collection strategies.
For instance, it incorporated not only phone interviews but also field notes. On the other hand,
the study was only specific and tied to one data collection method, which was through interviews
(Tubaishat, 2019). As such, the second study had minimal bias compared to the first one.
Summary of findings of the research
The first study had 2087 medications selected, which were observed across 808 patients
in both the pre-intervention and post-intervention periods. Eighty-nine nurses took part in the

RESEARCH 5
study, and 30 errors were recorded. Twenty-four of them came from the pre-intervention period
and the rest from the post-intervention period.
On the other study, it was a largely diverse sample. Participants worked on various
hospitals and units while the nurses used the system differently since they had diversified
responsibilities. The nurses were registered and ranged between 24-48 years. Most of them had
between 1- 26 years of service in the nursing field and between 1 to 5 years using the ERHs
(Fanning, Jones, & Manias, 2016). The majority of the nurses were males, with only nine being
female. From the second article, some themes were recorded, which helped improve the research
findings and solutions.
The first article was one of the researches done on the impact of ADCs within an ED
setting observed before and after the intervention. On that note, previous studies only
investigated the use of automated drug distribution systems in geriatrics and intensive care. From
the study, there was a lower rate pre-intervention than how it was hypothesized and a lower rate
for the previous automated drug distribution research. The variations are due to the criteria in
which medication errors are stipulated. However, the study also had numerous limitations. First,
the medical selection and preparation activities were not interrelated to any specific nurses and
patients (Tubaishat, 2019). As such, the medication error clusters could not be detected through
the skills of the nurses or the complexity of the patient.
Additionally, nurses had to search for medication from a computer to enhance workflow.
As such, it led to a lack of interfacing with electronic prescribing or files from patients, which
were in use (Fanning, Jones, & Manias, 2016). Also, it meant nurses selected medication
randomly as long as they were available. As such, errors were prone to be encountered. The
research lacked an economic analysis. Thus, there lacked vital information, which the economic

RESEARCH 6
analysis could have provided. Lastly, the data collected was from two different EDs of the same
hospital. For instance, post-intervention was collected in the new ED while pre-intervention was
collected in the original ED. The influence of the new surrounding on medication errors could
not be quantified (Tubaishat, 2019). Therefore, the total reduction cannot be ascertained to be
from ADCs alone.
From the second article, the results from qualitative data depicted a deviating perception
among the nursing staff. Among the interviewees, there was a common belief that using ERHs
has improved the safety of patients. Nevertheless, some of the participants stated the cons of the
system. It is essential to note the differences in opinions reflect different experiences with the
system. One of the positives the respondents mentioned was the fact that patient safety was
introduced since the integration of the ERHs system. They help reduce problems brought by poor
handwriting (Soriano, 2013). Also, since the system automatically notifies the nurses about drug
and patient interaction, the users can be able to discuss how they can change a specific dosage.
From the findings, it could be notable that ERHs are easily accessible, available, and searchable.
From the research, the interviewees believed that sustainability is one of the features of
the ERHs system, which makes it efficient. The records could easily be found, and data can be
traced easily. Despite the positives, which were given about the system, there were few negatives
also. For instance, the participants mentioned how difficult it was to interact with the system on a
daily basis.
The potential threat to validity or trustworthiness.
From the first research, there are few important reliability issues. For instance, the fact
that it was one of the first researches to be conducted makes it unreliable. The research would
require more studies to be able to be adequately proven. In terms of trustworthiness, the

RESEARCH 7
participants were given memos so they could participate in the process at there will. As such, the
research would likely be unbiased (Centers for Disease Control and Prevention, 2011). As such,
from the research, it is evident that the implementation of the ADCs will reduce medication
errors in the ED and at the same time, increase patient safety.
In the second research, previous studies had been earlier conducted from a similar case.
However, they had used a different approach to this incorporated in the study. In terms of
trustworthiness, the participants were given memos so they could participate in there on will. As
such, the research would likely be unbiased (Bofetta, 2010). Also, the nurses stated how the
system helped them reduce certain discrepancies. Thus, it can be concluded that the research was
successful.
Focus design and how they add to a clinical issue.
Evidently, both researchers were aimed at improving patient safety by reducing errors.
Nurses have been taught how the ERHs software works; thus, they can adequately maneuver and
use it appropriately to ensure there are minimal cases of errors in the emergency department.
Improving the system will improve the clinical issues. Also, medical practitioners need to be
adequately taught about the system before they can be assimilated to the working staff. This will
aid in reducing future errors within the emergency department and the entire department of
health.

RESEARCH 8
References
Bofetta, P. (2010). Causation in the presence of weak associations. Critical Reviews in Food
Science and Nutrition, 50(S1), 13–16.
Centers for Disease Control and Prevention. (2011). CDC morbidity and mortality weekly
reports (MMWR). Retrieved
from http://www.cdc.gov/mmwr/mmwr_wk/wk_cvol.html
Fanning, L., Jones, N., & Manias, E. (2016). Impact of automated dispensing cabinets on
medication selection and preparation error rates in an emergency department: a
prospective and direct observational before‐and‐after study. Journal of evaluation
in clinical practice, 22(2), 156-163.
Kasmel, A., & Tanggaard Anderson, P. (2011). Measurement of community empowerment in
three community programs in Rapla (Estonia). International Journal of
Environmental Research and Public Health, 8(3), 799–817.
Minkler, M. (2012). Community organizing and community building for health and welfare (3rd
ed.). New Brunswick, NJ: Rutgers University Press.
Soriano, F. I. (2013). Conducting needs assessment: A multidisciplinary approach (2nd ed.).
Thousand Oaks, CA: Sage Publications.
Tubaishat, A. (2019). The effect of electronic health records on patient safety: A qualitative
exploratory study. Informatics for Health and Social Care, 44(1), 79-91.

RESEARCH 9