Analysis of Medication Administration Approaches: A Comparative Report

This report provides a comparative analysis of two approaches to medication administration: 'Back to Basics' and 'Do Not Interrupt.' The 'Back to Basics' study aimed to reduce medication administration errors in the emergency department through educational intervention, while the 'Do Not Interrupt' study evaluated techniques to minimize non-medical interruptions during medication administration. The report details the methods used in each study, including participant demographics, interventions, and data collection techniques. Key findings from both studies are presented, along with critiques of their methodologies, focusing on the sufficiency of the methods, sample sizes, and internal/external validity. The report concludes by comparing the two approaches, highlighting their significance in contributing to effective medication administration and patient safety, while also discussing factors such as drug information, the clinical environment, and the importance of error reporting. Desklib offers this and other solved assignments to aid students in their studies.

Running Head: APPROACHES TO MEDICATION
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Contrast and Comparison of the Approaches to Medication
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Institution:

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Introduction
According to Blank (2011), the medication error is one of the most common mistakes
made during reporting errors in the emergency department. He further states that most of this
errors occur during the administration phase of the patient to the hospital. The purpose of this
study (Back to Basic) is meant to reduce the administration medical errors that often take place
in the emergency department. This errors get handled by reinforcing the underlying
administration medical procedures which will reduce the emergency errors in the department.
The study took three months where 75% of out of the 127 nurses participated in the research, and
the method that got used in the study was educational intervention. Moreover, the “Do not
interrupt" study aims at evaluating practical techniques that will decrease non-medical related
interruptions of the nurses during administrating medication (Westbrook, 2017). The study took
eight weeks where 227 nurses participated in the study, and they administered 4781 medications.
The general purpose of this paper is to have an understanding of the two studies and how they
relate to each other during medication administration.
Method
1. Back to Basic Approach to Medication
The purpose of the study was to reduce the number of administration medical errors that
often happen in the emergency department. According to Blank (2011), the following review
was a 3-month educational intervention which used a single group that was not randomized and
comparisons made on the pre-post outcome of the results. The educational interventions made
where to address the current medication errors experienced in the emergency department. The
methods used in the response are IV administration and preventing errors and the relevant
recommended practices that reduce medication administration errors. According to Huckles-

Contrast and Comparison of the Approaches to Medication 3
Baumgart (2014), research on medication errors are usually focused on isolated phases within the
medication administration process. On the study, 75 percent of the nurses out of a total number
of 127 participated in the study and three measures were used during the pre and post-
intervention of the survey (Blank, 2011). These methods were tests done to acquire knowledge
on the medical administration procedures and the use of the study to understand the behavior of
the participants when the recommended medication got administered. Another method used was
the use of chart reviews and voluntary error reports that gave understanding about the medical
administration errors that often occur. According to Blank (2011), the findings of the study show
that 91 percent of the nurses achieved a perfect score during the post-test while 69 percent
received a perfect score during the pre-test. From the post-survey, the nurses in their significant
proportions responded that they followed the recommended practice most of the time which
increased during 8 out of 10 questions in the survey. However, the results found from the study
did not reach the required statistical significance. On the other hand, during the chart review, the
nurses scored 299 during the pre-test while 295 scored during the post-test which still revealed
little change in the total medication errors. The survey method accounted for 25 percent of the
findings of the research while 24 percent was on the charts review. In the voluntary report, the
medication errors dropped by a significant number that is from 1.28 to 0.99 failures out of 1000
patients (Blank, 2011). Through the study, there were concerns about the effectiveness of the
methods used, and this provided the clinicians with better policy-making ideas that would
improve safety during medication administration (Acheampong, 2014).
Critique of the Back to Basic Approach to Medication
The use of educational intervention is certified as sufficient during the study because it
provides improved knowledge on the recommended medication administering practices though it

Contrast and Comparison of the Approaches to Medication 4
does not translate to be an essential change in medication administration practice. Furthermore,
the method was fit for the study because it provided some variation within the three months. The
sample size was 75% of the 127 nurses who participated in the survey was also sufficient for the
study. Therefore, the survey and chart review as the internal validity of the study because they
provide emphasis made by the research while the external validity can be referred to as the
educational intervention used in the research study as the general method (Blank, 2011).
However, the method used was not sufficient because it did not give the required change as
expected when the research began.
2. Do not Interrupt Approach of Medication
The purpose of the study was to reduce the number of interruptions that nurses of often
face while administering medication. According to Westbrook (2017), a random survey of an
eight parallel cluster is done in a major teaching hospital to understand the best method that can
be used to reduce interruption of nurses when they are administering medication. During the
study, randomization got done on four wards, and the interventions made were comprised of
putting on a vest during medication administration and patient and nurse education. Furthermore,
there were strategic measures put to divert any interruptions and creation of reminders. As the
study commenced, the intervention got blinded to the control wards then direct structured
observations were made on the administering medication processes. The primary findings of the
study were not related to the medication interruptions when administering proper dose
medication. The secondary results of the survey indicated the rate of multitasking and total
interruptions conducted by the study of the nurses' experience (Westbrook, 2017). From the
study, there was 4781 medications administered by 227 nurses over a span of 8 weeks (364.7
hours). Moreover, there were 57 interruptions out of 100 administrations that the nurses

Contrast and Comparison of the Approaches to Medication 5
experienced during the period where 87.9 percent of the disruptions were not related to any of
the medication tasks under observation (Westbrook, 2017). Moreover, there was a reduction in
the number of non- related medication interruptions which were 50 out of the 100
administrations made. There was also reduction in the medication route and ward type in the
control cluster that reduced by 15 of the unrelated medication interruptions out of 100
administrations. According to Westbrook (2017), this reduction was significant in that it had far
reduced number compared to the control wards. The post-survey study was completed by 88
nurses while nurses in the intervention ward reported that the vests consumed a lot of time and
cumbersome. The intervention was supported by 48 percent of the nurses for it to become
hospital policy.
Critique of the Do not Interrupt Approach of Medication
The method that was used for the study was not sufficient because it did not provide the
required change within the span of 8 weeks it was conducted. Furthermore, the sample size used
was adequate for the study because 4781 medications were able to be administered by the 227
nurses who participated in the study. Moreover, the method which is the use intervention got
associated with a significant reduction in the unrelated medication interruptions, and this
reduction has a significant effect on the medication error rates. The internal validity of the study
are the use of strategic measures put to prevent and interruptions, putting on of a vest during
medication administration and nurse and patient education. The external validity of the research
study was the randomization of four wards as the general method used in the research study.
Comparison of the Two Approaches to Medication

Contrast and Comparison of the Approaches to Medication 6
The ‘Back to Basic' and ‘Do not interrupt' approaches to medication have a significance
in contributing to factors that affect the effective administration of medication to patients. For
instance, during operations, some interruptions can occur, and the medical personnel got focused
on administering medication which reduces the medication errors that may arise. According to
Anderson (2010), drug information is also very crucial during the administration of medication
on the patient. It can be related to the drug packaging and labeling which is essential in
preventing any medication errors. For instance, some patients received an overdose of heparin
drugs due to misleading labeling and packaging and this medication error resulted in the death of
three infants. Another factor that may lead to clinical issues is the environment in which the
medication gets administered. For example, a research conducted in Malta shows that 37 percent
of the nurses agreed that physical tiredness was a key factor that led to medication errors when
nurses got tired and ignored some of the procedures required before giving medication
(Karavasiliadou, 2014). Moreover, observations made indicate that the rate at which medication
errors reported as voluntary is low (Aronson, 2009). It means that the ‘Do not Interrupt' approach
had to occur first so as for the ‘Back to Basic' approach happens because the error may occur
during administering dosage to the patient. From this article, we can understand that ‘Back to
Basic' and ‘Do not interrupt' approaches to medication have a connection in that the dosage
administered must be inaccurate for the medication error to occur. The ‘Do not Interrupt’
approach can be stated as the most significant method because it’s the one that often occurs in
hospitals compared to the ‘Back to Basic’ method. Furthermore, the ‘Do not Interrupt’ approach
is the one that often happens before the ‘Back to Basic’ approach takes place. Therefore, it
essential when nurses get updates about the medication errors that may have occurred in their
facility so that they can understand the best ways of administering medication dosages thus

Contrast and Comparison of the Approaches to Medication 7
preventing any mistakes from happening in the future. It is essential when nurses understand the
errors that occur and the necessity of reporting them in case they occur (Svitlica, 2017).

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References
Acheampong, F., Anto, B. P., & Koffuor, G. A. (2014). Medication safety strategies in
hospitals–a systematic review. International Journal of Risk & Safety in Medicine, 26(3),
117-131.
Anderson, P., Townsend, T., & CCRN-CMC, C. B. (2010). Medication errors. American Nurse
Today, 23-27.
Aronson,J.K. (2009) Medication errors: what they are, how they happen, and how to avoid them.
QJM: An International Journal of Medicine, Volume 102, Issue 8, 1 August 2009,
Pages 513-521,https;//doi.org/10.1093/qjmed/hcpo52
Blank, F. S., Tobin, J., Macomber, S., Jaouen, M., Dinoia, M., & Visintainer, P. (2011). A “back
to basics” approach to reduce ED medication errors. Journal of emergency
nursing, 37(2), 141-147.
Huckels‐Baumgart, S., & Manser, T. (2014). Identifying medication error chains from critical
incident reports: a new analytic approach. The Journal of Clinical Pharmacology, 54(10),
1188-1197.
Karavasiliadou, S., & Athanasakis, E. (2014). An inside look into the factors contributing to
medication errors in the clinical nursing practice. Health science journal, 8(1).
Svitlica, B. B., Simin, D., & Milutinović, D. (2017). Potential causes of medication errors:
perceptions of Serbian nurses. International nursing review, 64(3), 421-427.
Westbrook, J. I., Li, L., Hooper, T. D., Raban, M. Z., Middleton, S., & Lehnbom, E. C. (2017).
Effectiveness of a ‘Do not interrupt’bundled intervention to reduce interruptions during
medication administration: a cluster randomised controlled feasibility study. BMJ Qual
Saf, 26(9), 734-742.