Addressing Medication Errors: Research Implementation Plan

Introduction

The problems of medication error and issues about drug reconciliation play a highly adverse role in the contemporary medical care setting. It is stated that adverse drug events take place in the percentage of cases that fall within the range from 5% to 40% for hospitalized patients, and within the range from 12% to 17% for post-discharge patients (Mueller, Sponsler, Kripalani, & Schnipper, 2012). Medical errors are also very costly; it is estimated that in 2008, for example, they cost the U.S. nearly $19.5 billion (Andel, Davidow, Hollander, & Moreno, 2012). Thus, it is paramount to find out what leads to medication errors to be able to take action to address these causes and decrease the frequency of medication error occurrence in the medical setting. Therefore, this paper details the implementation of a research project aimed at uncovering the reasons for drug errors and problems with medicine reconciliation in the hospital setting.

A Step by Step Instruction for Implementation

On the whole, it is possible to implement the medication error and medication reconciliation research project in five main steps. These steps will include the creation of questionnaires for the interviews; contacting the Chief of Hospital Operations of the target hospital; gathering the sample of participants who will be interviewed for the proposed project; conducting the interviews, and analyzing the data which will be gathered throughout the project. More details related to each phase of this procedure are provided below.

Phase 1

At this step, the researcher will have to create the questions for the interviews which will be conducted with the participants of the study. It is paramount to stress that, since the sample will include two main types of participants, that is, health professionals and patients, it will be required to create two different questionnaires – one for each type of the participants. These questionnaires will be comprised of five open questions each, formulated in a manner which will prompt the respondents to reflect upon their experiences about the medication error and the problems which caused issues with medicine reconciliation, and give a textual answer to these questions (Denzin & Giardina, 2016). It should also be stressed that at the beginning of the questionnaires, a form will be included that will ask for the informed consent of the participants to take part in the study.

Phase 2

After the creation of the questionnaires, it will be needed for the researcher to contact the Chief of Hospital Operations of the target hospital (the Tisch Hospital, which is located in New York City, NY). The researcher will make a phone call to the Chief of Hospital Operations and will ask for a face-to-face meeting aimed at discussing the details of the research with the hospital’s official and gaining his or her permission to carry out the study. On the agreed date and time, the researcher will go to the office of the Chief of Hospital Operations, explain to him or her the nuances of the study, its importance, and significance, and ask for permission to conduct the research. It is expected that the Chief of Hospital Operations will allow to carry out the study; in the (unlikely) case of failure to obtain the permission, the researcher will have to choose a different hospital for the study.

Phase 3

After the permission to conduct the study will be obtained, the researcher will contact the potential participants (nearly five doctors, eight male patients, and seven female patients) by giving them requests to take part in the study (via the Chief of Hospital Operations). The explanation of the crux of the problem and the research study will be provided to the potential participants, and they will be asked to help with unveiling the causes of the frequent medication errors in the health care system. Once enough individuals will agree to take part in the study, the recruiting process will be ceased.

It should also be noted that, once the first participants are recruited, it will be possible to start the interviewing process, for not all the respondents need to be interviewed simultaneously, and some of them might become unavailable at a later date.

Phase 4

Once at least some participants are recruited, they will be interviewed by the researcher using the previously created surveys. The interviewees will be asked to provide their answers to the questions in an essay format. In addition to that, the interviews will also be tape-recorded to permit gathering more precise information from them. It is expected that each interview will last for nearly 30 minutes, but the participants will be allowed to take their time answering the questions if they desire to, to ensure that they provide full answers which comprehensively describe their opinions about the issues in question.

Phase 5

Finally, after the interviews are conducted, the researcher will be able to analyze the data gathered throughout the study. It will be needed to employ qualitative methods for data analysis (Denzin & Giardina, 2016). In particular, it might be decided that coding will be an appropriate technique for data analysis, in which case the texts gained during the interviews will be subjected to coding techniques to identify the main themes emerging in the responses of the participants (Saldaña, 2013), which may be employed to explain the potential causes of medication errors and the problems related to drug reconciliation in the given setting.

The timeframe of the Project

Table 1 below presents the detailed timeframe of the project, explaining how much time is expected to be required to carry out the steps outlined in the previous sections of this paper.

The phase of the Project Activities to Be Carried Out Expected Time Requirements Justification
Phase 1 Developing the interview questions for the health care professionals

Developing the interview questions for the patients of the hospital

1 week Not much time will be needed since the literature review has already been conducted; nevertheless, this phase cannot be done in only a few days because the researcher will still have to consult with literature
Phase 2 Contacting the Chief of Hospital Operations

A face-to-face meeting with the Chief of Hospital Operations to obtain permission

1 week It is assumed that the Chief of Hospital Operations will find time for the meeting within 1 week
Phase 3 Recruiting participants 2-5 weeks It is expected that most patients will agree to participate in the study, but the researcher might have to wait until, e.g., they feel well enough to give the interviews. Also, not all the patients asked to participate in the study might have much to say, in which case it will be needed to recruit other respondents
Phase 4 Interviewing participants 3-8 weeks This phase may take a large amount of time because the interviews are expected to last for at least 30 minutes each, and the interviewer might have to wait until the time when it is convenient for the participants to give interviews
Phase 5 Analyzing the data 5-8 weeks The procedure of data analysis might take much time due to the need to work with a large amount of qualitative information gathered throughout the study

Table 1. A detailed timeframe of the project.

Required Budget

On the whole, it is possible to implement the proposed project without any substantial financial investment (which also means that it can be implemented by a student); the only necessary spending will be to cover the costs of printing questionnaires and forms. However, if the researcher decides to transcribe part of or all the audio recordings made during the interviews, this will require additional funding, depending on how much of the recording will need to be transcribed.

It is also possible to pay the participants some money for the interview, but giving them much money should probably be avoided to ensure that they participate because they have what to say, and not simply because they want to make some additional money.

Other Resources Needed

It is expected that apart from the time, the access to the phone, the computer, and the Internet, as well as some money to cover the stationery needs of the research, no other resources will be required for the implementation of the proposed project.

Conclusion

On the whole, it should be stressed that medication errors and problems with drug reconciliation lead to highly adverse outcomes for the patients, and cost the U.S. considerable amounts of money. The proposed study might help uncover the reasons for these problems. To conduct the study, a five-step process will have to be implemented, which is expected to take several months to complete.

References

Andel, C., Davidow, S. L., Hollander, M., & Moreno, D. A. (2012). The economics of health care quality and medical errors. Journal of Health Care Finance, 39(1), 39-50.

Denzin, N. & Giardina, M. (Eds.). (2016). Qualitative inquiry: Past, present, and future: A critical reader. New York, NY: Routledge.

Mueller, S., Sponsler, K., Kripalani, S., & Schnipper, J. (2012). Hospital-based medication reconciliation practices. Archives of Internal Medicine, 172(14), 1057-1069.

Saldaña, J. (2013). The coding manual for qualitative researchers (2nd ed.). Los Angeles, CA: Sage.

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StudyCorgi. 2020. "Addressing Medication Errors: Research Implementation Plan." October 14, 2020. https://studycorgi.com/medication-mistakes-and-mediation-reconciliation-issues/.

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