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“Antecedents of Severe and Non-Severe Medication Errors” by Chang


In the world of constant dangers for medical support, people are trying to be more conscientious about the appropriate medication without the drawbacks of the personnel. In other words, the idea of medicine should contemplate the idea of professionalism and the constant process of qualification improvement. The problem of nursing systems and the work of Medicare services in terms of making no antecedents essential for the patients are disclosed in the article Antecedents of Severe and Nonsevere Medication Errors by Chang & Mark (2009).

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The paper is devoted to a critical analysis of the article in terms of the reality in the healthcare domain and previous experience. All in all, the idea of good services is emphasized in it due to the research provided by the authors. In this respect, the critique of the article presupposes the terms of a rational approach to the essence and significance of the article and findings which were gained.

Article Critique

The approach of the theme implemented in the article is based upon the previous studies and research on nursing systems and their evaluation for the contemporary situation with the healthcare reform and work of nurses assisting in the administration of healthcare services. Work dynamics and RN hours were made special emphasis due to the great concernment in the antecedents of severe and nonsevere medication errors.

In this respect, the authors used data from 279 nurses. The research was fixed due to the primordial longitudinal approach of six months. Here one should understand that the major point maintained in the research deals mostly with the quantitative method of analysis. However, the glimpses at the qualitative dimension are maintained based on rational and sequential findings correlated with the cases of severe and nonsevere medication errors.

Looking at the highlighted idea of professional approach in the study, the researchers are united in the idea that the professionalism of nurses should be enclosed into the applicable educational background. Moreover, in recent years the rationale for the prediction of any error in medication was identified and further stated according to the factors which are inconvenient to modify. The advantageous side of the article is presupposed with the idea of the current problem of medication errors in nursing being unsolved yet and representing a perpetual and essential risk for the patients.

The process of hospitalization due to some previous studies referred to in the article asserted multiple facts of the medication errors. It is not surprising that such statistics are growing day by day and imply today the main challenge for nursing systems and the role of a nurse in such a responsible field of activities.

The points of error-producing conditions are considered with work-environment factors, technological improvements, team and person factors, several characteristics, and peculiarities of patients. Making assumptions of these factors, it is necessary to admit that the work environment is the domain where work relationships and appropriate technical and material support should be united in the urge for making conditional background colored with sufficient education and knowledge base. Collaboration management is significant to outline in team and person factors. The aim for making communication sustained and versatile according to the professional themes is the way out for having fewer errors and in mutual consulting provided within nurses.

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Nonetheless, apart from the personal attitude toward the personnel of the hospital medics should be aware of the objects of their straightforward intentions in the workplace. Here the article underlines the personal characteristics of patients as of the age, health conditions, and possibly previous hospitalization. As a matter of fact, this approach should be born in mind with special tints on the whole concernment of nurses. However, a nurse should not exaggerate the real data about a definite patient.

Good-fitting versus poor-fitting model is discussed in terms of the techniques and methodology used while searching for results. Nevertheless, the root means a square error of approximation (RMSEA) is used in medical practice for making a decrease of errors more viable and helpful for current hospitals throughout the United States. The procedure measurements were provided with both theoretical and practical sides. It is so because in the first stage of the experiment the staff nurses were given questionnaires to detect the current level of nursing within them. Second, the practical approach was shaped in terms of gathering data out of the practical dimension of the experience.

Thus, the bilateral nature of the research was aimed at gaining more argumentative material for further conclusions. The reliability of the procedure is applicable due to the logical and rational interaction of these two constituents; experience (along with knowledge) and practical implementation. Antecedents in the medical outlook should be deeply investigated with proper evaluation of them for the future. The procedure and methodology of the research outlined this standpoint with more glimpses at the diversity of aspects being examined when talking about medication errors.

The authors were not categorical in their survey on the factors which are influential in terms of analyzed medication errors. Hence, Chang & Mark (2009) are apt in the article to note several reasons for having an idea of these negative cases apparent for many hospitals. The concept of the medication error is supposed by the authors more with the inappropriate administering of the medication. The point on prescribing is considered to be of less importance.

According to the operational side of the research, the wholeness of the problem was defined in the article in the following way: “Operationally, we defined medication errors as the wrong dose, wrong patient, wrong time, wrong drug, wrong route, or omission” (72). This is why the versatile nature of the research is advantageous and paramount for having the database checked in terms of new approaches in medication as well as the current grounding of the society as of the healthcare services. All in all, dependent variables as well as independent variables are selected and promoted in the research according to the general patterning of these points in research.

However, the distinctive feature of the article is definitely in its contemporary survey. Moreover, the research is worth and significant for its “fresh” and updated detailed information about a current problem in Medicare services. As far as it is seen today in the US, the reform process which is delayed since the time of the former president George Bush Sr. represents today one of the most obvious problems in healthcare. It is due to the insufficient and unequal opportunities within Americans of different strata of the society. In this respect, the research by Chang & Mark (2009) touches upon the problem of so-called market relationships between the national hospitals and people of different material standing. Here various biases may emerge within nurses in the question of whom to serve first of all.

The results displayed descriptive statistics about the main objectives of the research. All data are correlated to showing the average possibility of errors occurrences on each nurse unit. Thus, the idea of antecedents in the sphere of severe and nonsevere medication errors is probable for nurses whose BSN rating is increasing. The ratio showed that with the increase of the percentage of BSN-prepared nurses appears a relevant decrease of errors in nursing.

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That is why the problem of antecedents in terms of their relation to medication errors straightforwardly touches upon the educational and experience level of nurses notwithstanding their nursing units. Hence, the initial goal of the research indicated one of the main assertions by Chang & Mark (2009) which as follows: “In contrast, nurses’ experience had a significant nonlinear relationship with nonsevere medication errors only and the shape of the relationship was opposite to that of nurses’ educational level (p<0.01)” (74).


Looking at the survey provided by the article, there is no doubt that, first of all, the problem of medication errors is essential for healthcare establishments. Second, the idea of its decrease is outlined with more BSN preparation for the nursing staff with the further step-by-step rise in nursing units. The objectives maintained in the research are considered to have a mere extent of objection. In particular, the research showed that for the improvement of healthcare services there should be more glimpses at the educational experience framework of a nurse. In this respect, the impulse for more accuracy in working with patients and in the team of co-workers will provide greater concernment about standpoints of the profession.


Chang, Y.K. & Mark, B. A., (2009). Antecedents of severe and nonsevere medication errors. Journal of Nursing Scholarship, 41(1), 70-78.

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