The practice problem selected for this project is that insufficient nurse staffing leads to medication errors. A medication error is a preventable occurrence in the hands of a healthcare provider leading to or causing inappropriate medication use, potentially resulting in patient harm. Medication errors in healthcare environments may occur due to some reasons, but understaffing is a leading work environment cause that results in such errors.
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Understaffing can lead to workload pressures, interruptions, poor standardization of procedures and protocols, and limited time frames (World Health Organization, 2017). Meanwhile, medication administration to patients is a highly detailed and critical process that requires focus and attention. Without an appropriate staffing level to complete all necessary tasks, nurses are forced to juggle responsibilities alongside medication distribution.
The importance of the concern/problem to nursing and healthcare
This is an important issue in terms of healthcare delivery because the medication is a vital part of providing care and the healing process. Patients rely on medication for their health and expect medical professionals to provide them with appropriate drugs for their well-being. Therefore, when errors occur, it disrupts proper care and can potentially cause harm leading to patient adverse events. This is highly detrimental and dangerous both ethically and practically.
The scope of the concern
Medication errors in hospital environments are prevalent, with 46.5% of patients receiving at least one wrongful drug and 12.8% experiencing an adverse event (World Health Organization, 2016). Medication error remained at the top of the perceived and data-recorded patient adverse events in cases of understaffing. Medication errors accounted for 36.9% of errors when performing tasks (Kang, Kim, & Lee, 2016).
The evidence needed for change
With facilities with a higher percentage of nurses and a lower ratio of patients reported fewer cases of medication errors. Meanwhile, cases of higher workloads due to understaffing saw an increase of 1.23 times in medication errors (Kang et al., 2016). Problems of nurse staffing continuously remain a top reason given by medical professionals as a contributing factor to medication administration errors. This is due to nurses being disrupted in their tasks to perform other duties, making transcription-related errors, and a lack of information or guidance on medication and patients since there is a constant rotation of nurses among wards (Hammoudi, Ismaile, & Yahya, 2017).
The elements of the PICOT question
- P- Population and problem – Nurse understaffing resulting in medication error leading to patient adverse events.
- I- Intervention – Improve staffing and nursing rotations to provide proper time and conditions for medication administration.
- C- Comparison – Maintain current level of staffing which is inadequate.
- O- Outcome – Decreased instances of recorded medication errors as well as patient adverse events which occur due to drug mistakes.
- T- Time frame – 8 weeks to see maximum outcomes.
The PICOT question in the standard PICOT question format (narrative)
In nurse employees (P), what is the effect of improving staffing level (I) on medication error and drug-related adverse outcomes rates (O) compared with maintaining current understaffing levels (C) within eight weeks (T)?
The PICOT question in the standard PICOT question format (separately)
- P – nurse employees
- I – improving staffing levels
- C – maintaining current understaffing
- O – medication error and drug-related adverse outcomes rates
- T – 8 weeks
The key search terms and phrases for the literature search
Nurse understaffing, nurse staffing levels, medication errors, drug-related adverse events, drug errors, nurse medication errors.
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The theoretical framework/nursing theory that can guide the EBP project
Watson’s caring theory can be potentially applied to this EBP project. Medication administration is a caritive process, and it is a critical nursing practice. Practicing some of the principles outlined in theory, such as remaining calm under stress, focusing before beginning the process of medication administration, and respecting co-workers’ attention and privacy when they are busy with medications, can be applied in practice as strategies in addition to the intervention to reduce distraction and poor communication that initially lead to errors.
Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2017). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian Journal of Caring Sciences, 32(3), 1-9. Web.
Kang, J.-H., Kim, C.-W., & Lee, S.-Y. (2016). Nurse-perceived patient adverse events depend on nursing workload. Osong Public Health and Research Perspectives, 7(1), 56-62. Web.
World Health Organization. (2016). Medication errors. Web.