Critical Analysis: Medication Administration Research Papers

This report critically analyzes two research papers focused on medication administration. The first paper, a qualitative study, explores challenges faced by registered nurses in medication administration, highlighting issues of internal and external validity. The second paper, a quantitative interventional study, examines methods to reduce drug preparation errors, particularly in patients with feeding tubes. The report compares and contrasts the methodologies, findings, and validity of both studies, evaluating their contributions to understanding and improving medication safety. It discusses the strengths and weaknesses of each study, considering factors such as selection bias, confounding variables, and the impact of intervention programs. The analysis emphasizes the importance of collaborative responsibility, education, and systematic interventions to minimize medication errors and enhance patient outcomes. The report concludes by underscoring the significance of these research findings in guiding best practices within healthcare settings, regardless of the specific patient population or clinical environment.

Running head: MEDICATION ADMINISTRATION 1
Medication administration
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MEDICATION ADMINISTRATION
Error related to medication is a cause of concern within the medical fraternity. A research
based study conducted by Härkänen, Blignaut, and Vehviläinen-Julkunen (2018), worked on
exploring the possible causes that lead to possible medicinal errors. The study can further
propagate a clear idea about enhancing the quality of nursing practises for better patient health
outcome. The essay thus works on examining the provided research articles that is centred
around the issues of medication error and how it can be addressed for better results. The essay
carries out critical comparison between the two research papers while bringing out their actual
validity.
The first paper concentrates on the focus group discussion of the registered nurses;
coupled with the challenges in the process of medicine administration. The research in the
current context makes use of focus group related interview among a sample size of 20 nurses.
The nurses were interviewed within their professional settings. The analysis conducted in the
mentioned scenario was based on inductive content analysis. The results exhibited the fact that
the nurses were subjected to series of challenges during the course of medication. The challenges
found through the course of research was further segregated into themes for better understanding
of the research findings. Thus, it can be conclusively stated the process of medication
administration was subjected to flaws and even the registered nurses described many internal and
external challenges that can be related to medication administration. The research in the current
context drew the conclusion that nurses are responsible for the work related performance that is
inclusive of patient safety. The aspect of patient safety is of prime concern that can be
maintained through implementation of effective collaboration, while providing proper education
to the targeted population in regards to medication administration

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The second research article is seen to focus on the wrong drug preparation for patients
making use of feeding tubes. Combined intervention programs are often termed as effective tools
that can be implemented for ensuring limited medication preparation errors. However, till date
there has been limited research in the mentioned field and even if tested, computerized
physicians were used. Thus, the prime objective of the mentioned research paper was to design
and evaluate an intervention based program tailored as per the healthcare settings without the
preference of such pre-determined conditions. The research makes use of methodological
intervention of pre or post-operative ICU patients of specific wards. The results evaluated the
fact that drug preparation is an important aspect that works on maintaining the health of the
individuals. The result provided a clear idea that intervention program is highly significant in
reducing the error related to medicine crushing. Hence, it can be concluded, the implementation
of systematic interventional program can work on reducing the rate of wrongly prepared solid
preoral drugs. The result additionally provided a clear idea to the fact effective measures can be
undertaken for ensuring better health practises among the patients
Considering the first research conducted by Härkänen, Blignaut, and Vehviläinen-
Julkunen (2018), the researcher adopted qualitative study design where they conducted an
interview of 20 registered nurses; coupled with the challenges in the process of medication
administration. The internal validity of the study depends on certain factors such as Attrition, a
random section of the participants and confounding factors (Belin et al., 2016). Considering the
internal validity of the study, the study randomly selects registered nurses from the two wards of
the hospital. While it has the minimum selection, it randomly selects registered nurse from each
ward which further indicates internal validation of the study. However, Connelly (2016),
highlighted that the presence of the confounding factors may impact the internal validity of the

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study as confounding factors are the variables which influence the result of the study. Taking a
deep insight into the situation, interviewer’s skills and attributes might influence the nature and
quality of the gathered data which further affected the result of the study. The bias of the
interviewer and the participants also influence the study since the result of the interview reflects
the personal feeling, perception, and opinion of the study which further influence the internal
validity of the study (Andrade, 2018).. Hence, the study showed minimum internal validity. On
the other hand, the external validity of the study depends on study design and inclusion criteria.
Taking a deep insight into the research, the researchers adopted a qualitative study design which
is most suitable for gathering perception and feeling of the study where researchers had inclusion
criteria for the research (Lather, 2017). In this context, it can be said that the internal and external
validation of the study is moderate and hence it is a useful article for gathering the perception of
a registered nurse and identifying factors behind medication errors.
Considering second research conducted Lohmann et al. (2015), researchers adopted an
experimental (quantitative) study where researchers conducted an interventional cohort study
based on ICU patients of two wards of a large tertiary care university. As discussed above, the
internal validity of the study depends on certain factors such as attrition, a random section of the
participants and confounding factors (Belin et al., 2016).
Considering the internal validity, the research has selection bias and participants are not
randomly selected rather they only ICU patients were selected for the study. Considering the
confounding factors, tube clogging, adverse events or other forms of patient harm were not
measured by the researchers but these factors may impact the study. However, as the study is
experimental, no participant’s bias was observed. Moreover, a significant number of studies
already demonstrated that drug preparation errors may result in patient harm which further

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affected the internal validity of the study (Andrade, 2018). Considering the external validity of
the study, the researchers used a cohort study for evaluating the impact of the intervention which
influenced external validity (Lather, 2017). Hence, this study is externally valid compared to the
previous study and can be used in providing direction for minimizing medication error.
The comparison between both the research paper can be based on the fact that it discusses
about the possible medication related errors. The research study in both the cases makes use of
qualitative and quantitative studies. However, the aspect of concentrating on the research papers
was highly focussed in case of second research journal. Research conducted by Härkänen,
Blignaut, and Vehviläinen-Julkunen (2018) makes use of focus group for understanding the
exact problem in regards to medication administration. However, the research is challenged to
infer an additional consensus from the focus group. The setting used in case of both the journals
was systematically based in hospital settings. However, the problem in both the cases answered
were same; only the approach was differently undertaken. The specificity of the second research
journal was clearer than the first one due to the methodological intervention Härkänen, Blignaut,
and Vehviläinen-Julkunen (2018) makes use of qualitative study that further works on providing
the pattern within which the targeted population, nurses are seen to show better results of
professional medicinal practises.
Fortunately, the research study provides a clear idea to the fact that medicine
administered errors are a common phenomenon. However, it should be concentrated while the
former research journal produced by Härkänen, Blignaut, and Vehviläinen-Julkunen (2018)
discussed the possible causes that lead to wrongful administration of medication, and explained
the reasons for the possible problems. the research conducted by Lohmann et al. (2015),
evaluated the possible effects of providing the registered nurses with training; while evaluating

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the efficacy of the same. In simple words it can be stated while the first journal worked on
finding the possible causes, the second research paper formulated by Lohmann et al. (2015),
suggested with suitable intervention that provided with recommendations that can be
implemented for ensuring better health outcomes at practical settings.
The second research journal made use of quantitative research study and the required data
was rightly collected from the research participants. Conclusively, it can be stated the process of
medicinal administration is often laced with challenges leading to vulnerable errors. The results
provided in case of first research journal provide suitable intervention that work on stressing over
the collaborative responsibility of maintaining the required staffing and educational level among
the nurses. However, interventional study conducted by Lohmann et al. (2015), conclusively
state the fact implementation of the chosen interventional program is seen to have better impact
on the knowledge of the nurses. In addition to that inappropriate preparation of solid drugs,
especially if crush inappropriately or even suspended with changed formulation is likely to give
negative outcomes. The study additionally linked the impact of the stated interventional
programs in regards to hazardous drugs such as antivirals. The result obtained from the
mentioned studies provides suitable recommendations that the mentioned interventional
programs can be escalated and potentially suitable for comparable hospitals for ensuring safe
administration of drugs for hospitalized patients with feeding tubes.
However, it should be taken into consideration that medicine administration is not limited
to hospital settings and definitely not to the patients with feeding tubes. The research conducted
by Härkänen, Blignaut, and Vehviläinen-Julkunen (2018), understands the mentioned prospects
and works on analysing the possible causes of medicine administration errors while providing
suitable recommendations for reducing the same irrespective of the hospital setting. However,

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the use of interventional studies often prompts the researcher to consider the baseline values. The
baseline value was collected in case of second research study prior to the implementation of
interventional studies; for understand the impact of research variables on one another. The
mentioned study was thus shown to exhibit similar levels of baseline interruption types and even
the rates.
The research in both the scenarios was obtained from direct observation often promotes a
risk related to alteration of research data due to the fear of being observed often termed as
Hawthorne effect (Lather, 2017). However, the use of baseline data can be termed as the right
step in case of second scenario. The qualitative research in case of first research explains the
human experiences. However, the aspect of credibility within the research could have been
increased, provided the participants were transcribed within the right environment. Through the
analysis of the chosen research journals, it would be fair enough to conclude the fact that there
remains significant barrier in regards to medicine administration. However, it should be noted;
although the limitations within the studies were identified and possible steps were undertaken for
ensuring positive practise that can be implemented for better professional outcome. The
reliability can be further improved if the mentioned research is implemented in professional
practise.

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Reference list
Andrade, C. (2018). Internal, external, and ecological validity in research design, conduct, and
evaluation. Indian journal of psychological medicine, 40(5), 498.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149308/
Belin, T. R., Jones, A., Tang, L., Chung, B., Stockdale, S. E., Jones, F., ... & Ong, M. K. (2018).
Maintaining Internal Validity in Community Partnered Participatory Research:
Experience from the Community Partners in Care Study. Ethnicity & disease, 28(Suppl
2), 357-364. https://europepmc.org/articles/pmc6128339
Connelly, L. M. (2016). Trustworthiness in qualitative research. Medsurg Nursing, 25(6), 435-
437.
https://pdfs.semanticscholar.org/b467/089d0422a83fe1d5715d837dd39d9fce4e7c.pdf
Härkänen, M., Blignaut, A., & Vehviläinen-Julkunen, K. (2018). Focus group discussions of
registered nurses’ perceptions of challenges in the medication administration process.
Nursing & Health Sciences, 20(4), 431-437.
https://onlinelibrary.wiley.com/doi/10.1111/nhs.12432
Lather, P. (2017). Validity, qualitative (2007). In (Post) Critical Methodologies: The Science
Possible After the Critiques (pp. 75-80). Routledge.
https://www.taylorfrancis.com/books/9781315619538/chapters/10.4324/9781315619538-
15
Lohmann, K., Gartner, D., Kurze, R., Schösler, T., Schwald, M., Störzinger, D., . . . Seidling, H.
M. (2015). More than just crushing: a prospective pre-post intervention study to reduce

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drug preparation errors in patients with feeding tubes. Journal of Clinical Pharmacy and
Therapeutics, 40(2), 220-225. https://onlinelibrary.wiley.com/doi/abs/10.1111/jcpt.12250