PCAL 401208 - Guided Review of Nursing Research Literature

This assignment presents a comprehensive analysis of nursing research, focusing on qualitative and quantitative studies related to medication administration and workplace dynamics. It dissects the aims and significance of the studies, the methodologies employed, including research design, sampling techniques, and data collection methods. The analysis further examines data analysis techniques, the findings and results, and the limitations and recommendations of the studies. The assignment also addresses the experiences and perspectives of nurses, particularly recent graduates, on medication safety practices, workplace supports, and disruptive behaviors, highlighting factors that contribute to medication errors and potential solutions. The guided questions template ensures a structured approach to evaluating the research papers, enabling a thorough understanding of the research process and its implications for nursing practice.

Guided questions Answer Template (Please do not Remove the questions)
Guided Question Qualitative Study Quantitative Study
1. Aim and
Significance (5
marks 200 words)
a. What was the aim and
significance of the study?
Aim- The study aims at exploring nurses’
experiences with previous medication
administration errors and analysing their
perspectives on how to safely prevent
these medication administration errors
(Cloete, 2015).
Significance – The study provides an
insight into nurses’ practise associated with
medication administration errors. The aim
of the study is important to understand the
fine acumen developed through
experiential learning (Grace et al., 2017)
and how they can be scrutinized to
implement safe clinical practices.
Aim- The study aims at understanding medication
administration errors by new nurses and their
standpoints on prevention of these medication
administration errors.
Significance – Workplace disruption (DeFraia, 2016) is
a major issue in the organisations worldwide and the
‘issue’ can be fatal when it happens in a healthcare
setting. New graduate nurses finds it difficult to adjust
to new work environments with dominance of senior
practitioners (Sahay, Hutchinson & East, 2015).This
can disrupt the new graduate’s attention and focus in a
high strung patient environment leading to medical
administration errors.

2. Methods (10 marks
700 words)
a. Identify the
research design used
in the study and was
it appropriate for the
issue discussed?
A semi structured interview is used as a
data collection method. Consensus
meetings, coding along with author review,
author coding is used as data analysis
methods.
The design incorporates a mixed analytic
method for a crucial thematic analysis
(Braun et al., 2019). Mixed method
research provides more meaningful,
complete and purposeful approach
(Schneider & Whitehead, 2013). Thematic
analysis always extends a greater
theoretical freedom and flexibility which can
be used to decipher the ‘causes’ of error
experience and find out safety measures.
A survey (Couper, 2017) incorporated with an
explorative research design is used in the study. The
data of findings is then utilized to draw a correlation
between operational (practical) and conceptual
understandings (Smith & Liehr, 2018)
The research design used in the study is appropriate
for the study because descriptive researches often
provide an insight into real life experiences which is a
critical tool in establishing the goal of the study.
b. Discuss the sampling
technique, inclusion and
exclusion criteria used for
Snowball sampling method is being used.
(Palinkas et al., 2015).
A random sampling method is being used (Srivisut,
Paige & Clark, 2018).

the selection of sample in
the study Inclusion criteria – participants has to be
requested by email in first instance,
participants have to be registered nurses,
some nurses included in the study has to
be in managerial designation.
Exclusion criteria – similar attitude,
disruptive behaviour, absolutely novice.
Inclusion criteria – participants has to be recent
graduates from three Australian schools of nursing, and
the nurses should be within the first
18–24 months of clinical practice.
Exclusion criteria – disruptive behaviour, disruptive
addictive habits.
c.Explore the data
collection method and its
appropriateness to the
research design of the
study
Semi-structured individual interviews were
performed (where each interview lasted
approximately for about one hour to one
and a half hour. Potential barriers and
facilitators (Lavallée et al., 2018) were
identified while planning the framework of
an efficient clinical practise. Characteristics
of the practitioners involved in the study
along with the socio- cultural context of an
organisation was addressed as a part of
study. A reflection task was given to each
nurse regarding different safety measures
and best practises. Anonymity and wilful
withdrawal was reassured. Participants
Respondents were recruited from three participant
Australian college of nursing. The databases of these
universities were explored and about 427 respondents
were expected in the beginning. The research team did
not intervene directly but an administrator of each
university sent an email to each gradate. Email
reminders were sent for consecutive fortnights – to
improve response rates. Finally, 58 recent graduates
successfully finished the survey.
Given the aim of the research study, a descriptive
survey data collection method(Johnston, 2017)
provides a bulk data at a lower cost and moreover,
because of its statistical significance and precision of

were assured that the research is about
their personal reflection on best clinical
practices and their expressions and
opinions wold not affect their work status or
job security in their respective departments.
The interview process was described and a
written consent was taken from the nurses.
The data collection method is quite
appropriate because a semi-structured
interviews (McIntosh & Morse, 2015) are
good sources of reliable data which can
compared later. Moreover the participants
can express themselves to a greater
freedom and hence, it serves the core
purpose of a qualitative analysis.
results – survey method becomes an appropriate data
collection method.
3. Data analysis and
results (10 marks
600 words)
a. How was the data
analysed and was
it appropriate for
The semi structured interviews were coded
independently followed by comparison of
the codes until the coding tree arrived at a
Survey data was first downloaded properly from the
Qualtrics® online platform and then the data was
analysed using Statistic Package for Social Sciences

the study? consensus. First 15 interviews were applied
with consensus meetings plus coding while
the rest five interviews were analysed with
author coding and reviews. Through the
usage of consensus meetings – the most
useful themes were identified in regards to
prevention of medication errors in clinical
environment. The text fragments were then
scrutinized in accordance to the depicted
‘themes’ which are – nurse’s clinical role in
medication administration safety, nurse’s
capability of working ‘safely’ in the clinical
environment, a nurse’s adherence with the
clinical practise protocols that rationalizes
the ‘right’ and ‘wrong’ of medication
administration.
Coding is an important tool used for
independent interpretation of data and
then, a collective analysis. Overall, the data
analysis method is suitable choice for the
study.
(SPSS) version 20.
Descriptive statistics (George & Mallery, 2016). Logical
responses were identified sing the statistical package
and the ‘missing loops’ were identified. Spearman's
correlation analysis (Lee et al., 2015) was run on the
derived data to draw a ‘logical’ correlation.
The analysis technique uses a statistical and
correlation analysis. Correlation analysis are crucial to
understand ‘relationships’ between different data and
form a logical conceptual framework.

b. What were the
findings/results of the
study?
The research team approached 20 nurses
to participate in the study. All the nurses
voluntarily participated in the study. The
sample distribution was 5 males, 15
females and the sample’s mean age was
43 years. The sample size was contributed
by nurses of difference professional
experience - two nurse quality innovators,
two nursing ward managers, two directors,
five senior nurses and eight regular nurses
were the part of study.
Of these participant nurses, only the senior
and experienced were allowed to prepare
and deliver the medication. On application
of a consensus meeting:-
Three crucial themes could be identified:
(1)The registered nurses’ compliance with
clinical safety practices.
(2) Clinical responsibilities of a registered
nurse in day to day practise regarding
medication administration safety.
Majority of the participant new nurses were employed
in a full time job in community, medical or sugical
clinical environments. Only 34 nurses – which is less
than two third of total participants reported - that they
have made a clinical medication error. Cross
tabulations were devised in identification of a medical
administration ‘errors’ pattern and correlated to areas
of clinical environment the rate of occurrence. Of the
participants, 27 new nursing graduates' (employed in
surgical or medical units) reported that they have done
highest number of medication administration errors.
About 7 new nursing graduates did a similar error in
acute settings of a different speciality. This pattern was
not influenced by area of setting. A very simple yes or
no answering was used as a response from the nurses
to report about clinical medication errors. 35 nurses
reported clinical errors in medical administration and of
the whole sample, only 24 nurses reported that they
made no errors. About 5 nurses reported that non -
reporting is not a very important factor in determining it

(3) The capacity of the nurse to work
securely and safely in daily clinical practice.
as a cause for medication administration error.
Then the learning process in the clinical environment
was studied. In this regard, 39 reported that an in-
service education should be standardized in the clinical
setting, 42 recent nursing graduates said that presence
of a nurse educator in the clinical environment/ward
would promote on job learning, 37 nursing graduates
reported that clinical learning packages should be used
in the learning framework, 32 nurses reported that
pairing with experienced senior
Nurses is important to the learning process. 13 nursing
graduates reported that incorporation of ‘debriefing
sessions’ is vital to the on job learning process.
Relating disruptive workplace behaviour with erroneous
medication practices, less than quarter of participant
nurses reported the error occurred due to a constant
pressure faced by dominating behaviour of prescribing
doctors (n=11). It was also reported that bullying from
the senior nurses (n=17) to be a potential problem and
similar behaviour exhibited by the physicians (n=12) is
a potential cause of medication administration errors. It
was revealed that when a nursing graduate’s

competence was judged or doubted, it led to the
incidents of medication errors. Intravenous and
parental medication errors within a clinical environment
were reported to have a definite cause – like
intimidation from experienced colleagues (n=6). Likert
scale (one point five) was used to reveal an important
information - a feeling of reluctance amongst new
graduate nurses that hindered approaching fellow
nurses taking valuable medication administration
advice (n = 18) – resulted in medication administration
errors. There were instances when a nurse felt a
medications inappropriate to patient’s state and this led
to medication administration errors (n = 6) as well.
Next, another potential psychological issue was
identified – when the graduate nurses was actually
blamed or felt like they are being blamed for the
medication errors (which was in fact committed by
prescribing doctors) led to clinical medication errors (n
= 9). 12 participant nurses reported that the reason of
these medication administration errors was a constant
paranoia provoked by a blaming attitude of other

nurses.
c. Discuss the limitations
and recommendations of
the study?
Although the research study was done
within a closed setup. The results were not
very exclusive though, according to the
researchers.
The study recommends a synergistic
initiatives taken by nursing managers and
top notch administrators towards a
professionally driven practice environment
along with a shared multi-disciplinary
responsibility with young nurses.
According to the researchers, the selection of a
convenience sampling method and usage of self-
reporting are the major limitations. Another possible
limitation could be anxiety and fear which plays in the
psyche of new nurses, resulting in a behavioural
‘guarding’ towards fellow senior nurses while taking
advices on medical administration.
The study recommends modifications in graduate
nursing education so as to address the ‘study findings’
in an efficient way.
References:-
Braun, V., Clarke, V., Hayfield, N., & Terry, G. (2019). Thematic analysis. Handbook of Research Methods in Health Social
Sciences, 843-860.
Cloete, L. (2015). Reducing medication errors in nursing practice. Cancer Nursing Practice, 14(1).

Couper, M. P. (2017). New developments in survey data collection. Annual Review of Sociology, 43, 121-145.
DeFraia, G. S. (2016). Workplace Disruption following Psychological Trauma: Influence of Incident Severity Level on Organizations'
Post-Incident Response Planning and Execution.
George, D., & Mallery, P. (2016). Descriptive statistics. In IBM SPSS Statistics 23 Step by Step (pp. 126-134). Routledge.
Grace, S., Innes, E., Patton, N., & Stockhausen, L. (2017). Ethical experiential learning in medical, nursing and allied health
education: a narrative review. Nurse education today, 51, 23-33.
Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2018). Barriers and facilitators to preventing pressure ulcers in nursing home
residents: A qualitative analysis informed by the Theoretical Domains Framework. International journal of nursing
studies, 82, 79-89.
Lee, G., Singanamalli, A., Wang, H., Feldman, M. D., Master, S. R., Shih, N. N., ... & Madabhushi, A. (2015). Supervised multi-view
canonical correlation analysis (sMVCCA): Integrating histologic and proteomic features for predicting recurrent prostate
cancer. IEEE transactions on medical imaging, 34(1), 284-297.
McIntosh, M. J., & Morse, J. M. (2015). Situating and constructing diversity in semi-structured interviews. Global qualitative nursing
research, 2, 2333393615597674.
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative
data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and
Mental Health Services Research, 42(5), 533-544.
Sahay, A., Hutchinson, M., & East, L. (2015). Exploring the influence of workplace supports and relationships on safe medication
practice: A pilot study of Australian graduate nurses. Nurse education today, 35(5), e21-e26.

Schneider, Z., & Whitehead, D. (2013). Nursing and midwifery research: methods and appraisal for evidence-based practice.
Elsevier Australia.
Smith, M. J., & Liehr, P. R. (Eds.). (2018). Middle range theory for nursing. Springer Publishing Company.
Srivisut, K., Paige, R. F., & Clark, J. A. (2018, March). Correlated Input Strategies: Using Metaheuristics for Generating
Parameterised Random Sampling Regimes. In Proceedings of the Genetic and Evolutionary Computation Conference
(GECCO) 2018. ACM.