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Reducing Nursing Errors in a Medical-Surgical Unit


The topic and the nursing practice issue related to this topic.

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Common Mistakes in the Field of Nursing Practice

The rationale for the topic selection and the scope of the issue.

Errors are prevalent in the nursing profession, and they can have serious consequences, including putting the health of a large number of patients in danger of becoming ill or even dying as a result of their mistakes. Thousands of people have died as a result of pharmaceutical mistakes in the United States and throughout the world. A variety of causes, including weariness as a result of extended working hours, a nurse’s inability to pay attention, and carelessness, can all contribute to the mistakes. Nurses are capable of devising strategies that might assist in reducing the number of mistakes in the nursing profession, if not fully eliminating them altogether.


The practice problem in own words and the PICOT question

There has been an all-time increase in the number of common errors in nursing practice, and this is a concern in the field of nursing practice as well. Mistakes with medications, failure to provide enough care to patients, infections, and falls are examples of mistakes. The unfortunate reality is that these errors have devastating consequences, yet little has been done in most healthcare facilities to guarantee that they foster a safety culture with the goal of improving the health outcomes for their patients.

In reference to the above problem in nursing practice, the PICOT question was developed as follows: “Drug prescription mistakes (P), Effect on patient safety (I) Intervening by use of newly implemented guidelines (C) in the reduction of the death rate (O) within one year (T)?”

The systematic review chosen from the CCN Library databases

Lawati, M. H. A., Dennis, S., Short, S. D., & Abdulhadi, N. N. (2018). Patient safety and safety culture in primary health care: a systematic review. BMC family practice, 19(1), 104.

Other sources used for data and information

Cloete, L. (2015). Reducing medication errors in nursing practice. Cancer Nursing Practice, 14(1).

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Description: The safety culture of institutions is one of the factors highlighted in this article that contributes to medication errors. Nursing workload and patient acuity are among the topics covered, as are the potential distractions and delays that might arise during drug administration, as well as the intricacy of various prescription calculations and administration techniques.

Meurier, C. E., Vincent, C. A., & Parmar, D. G. (1997). Learning from errors in nursing practice. Journal of advanced nursing, 26(1), 111-119. Web.

Description: The study recommends that employees should be encouraged to accept responsibility for their errors within a supportive environment. Strategies should be created to manage mistakes more constructively.

Asensi-Vicente, J., Jiménez-Ruiz, I., & Vizcaya-Moreno, M. F. (2018). Medication errors involving nursing students: A systematic review. Nurse educator, 43(5), E1-E5.

Description: The findings indicated that little research has examined mistakes and near misses involving nursing students, despite the fact that existing data indicates a high rate of occurrence.

Summary of the main findings from the systematic review and the strength of the evidence

According to the findings of the paper, there are many different definitions of patient safety culture. But the most commonly used definition was that patient safety culture relates to shared beliefs, perspectives, skills and attitudes, and behaviors among staff members in a healthcare facility, which is supported by research. It was also shown that the majority of errors in nursing practice are caused by a breakdown in communication both inside and outside of the nursing practice, as well as poor relationships between care providers and their patients. The availability of safe electric sockets, the accessibility of the telephone, and the availability of medical tools were all identified as being essential in the patient safety culture.

Specifically, the study presents two methods that may be utilized in the assessment of patient safety culture. The Hospital Survey on Patient Safety Culture (HSOPSC) and the Manchester Patient Safety Framework are two examples of such surveys (MaPSaF). By using the HSOPSC tool, it was recognized that patient safety is a complicated and multifaceted issue.

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Overall, the paper admits that patient safety is critical in the delivery of high-quality health care and that it continues to be a major problem. Improved patient safety may be achieved by healthcare organizations first addressing and comprehending their own safety culture. The persuasiveness of the evidence When measured on a one-to-five scale, the systematic review has a strength of 5. This is due to the enormous amount of supporting evidence provided by systematic reviews. The article made use of 28 articles with a global distribution that included the United States, Germany, the Netherlands, Australia, the United Kingdom, Canada, Brazil, Turkey, Kuwait, and Saudi Arabia, among other countries.

Evidence-based solutions to consider for the trial project

Patient safety is the duty of healthcare administrators, who are responsible for developing processes and policies that will help in the development of a culture of patient safety. They should also learn leadership skills that will ensure that communication between patients and nurses is as effective as possible, as well as a system for collecting and keeping medical data for the patients under their supervision.

Translation (Action Plan)

Care standards, practice guidelines, or protocols to support the intervention planning

It is necessary to implement a complete learner-centered approach in order to improve the knowledge, skills, and attitude of nurses. Aside from raising awareness, nurses should also educate themselves on methods for improving patient safety and reducing malpractice amongst themselves.

The stakeholders and their roles and responsibilities in the change process

  1. Management: Managers are responsible for developing strategies and policies that will aid in the promotion of a safety culture in the nursing profession. The training of employees and the supervision of employees are essential aspects of managers’ roles in helping their teams develop solutions that may be applied to enhance healthcare results.
  2. Nurses: Primary care is the role of nurses when it comes to delivering care to patients. They contribute to the implementation of the strategies that have been created.
  3. Patients: They have a responsibility to provide the nurses with the greatest amount of cooperation possible. They should also bring up any mistakes that may have gone unnoticed by the nurses.

The nursing role in the change process

Nurses have an obligation to report any inaccuracies to the appropriate authorities in the institutions with which they are affiliated or contracted. The authorities can conduct an investigation into the faults and create steps that can be implemented in order to avoid similar blunders from occurring in the future. Nurses should also alert the appropriate authorities if they come across any potentially hazardous items while doing their duties, such as malfunctioning equipment or machinery. They should run through a checklist on a frequent basis to ensure that they have not overlooked anything.

The stakeholders listed by position titles

Pharmacists (4): It is imperative that they are involved in the promotion of patient health safety culture since they are able to spot prescription mistakes that are all too prevalent in a health care facility.

Nurse leaders (4): As well as carrying out the responsibilities of supervising nurses, they also serve as advocates for the reforms that must be adopted in order to enhance health outcomes.

The cost analysis needed prior to a trial

The most significant expense that will be required is that of training the key individuals who will be engaged in the creation and execution of the change strategy. Three pharmacists and five nurse leaders will be trained as part of the trial’s preliminary phase. The production and distribution of flashcards and leaflets, as well as the preparation of films to be utilized in training, will all be part of the awareness campaign. It is possible that the cost will increase as a result of this.


The process for gaining permission to plan and begin a trial

It is expected that the nurse leaders will get the go-ahead from the proper authorities. Their first step is to draft a letter to the executive team describing what the problem is, how it impacts nursing practice and health outcomes, and why immediate action is needed. Described in the letter will be the intervention approaches and an estimate of the anticipated benefits.

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The plan for educating the staff about the change process trial

People involved in the adjustments will be taught the importance of the changes and how to avoid errors, with an emphasis on better health outcomes. If the training is a success, it will ensure that all key stakeholders understand the need for change and are willing to accept it once it is put in place.

The implementation timeline for the change process

Oct. 8 to Oct. 21, 2021: Stakeholders training on the need and role of change.

Oct. 22 to Nov. 1, 2021: Preparation of materials needed in the advertisement

Nov. 2 to Nov. 15, 2021: the creation of public awareness on the policies and methods that will be implemented in order to reduce mistakes and promote patient safety.

Nov. 16 to Dec. 1, 2021: Evaluation of change process.

The measurable outcomes based on the PICOT

P- Errors in drug prescription

I- Patient Safety promotion

C – Intervening by use of newly implemented guidelines.

O- Death rate.

T- One year

Forms used for recording purposes during the pilot change process

Against each of the nurses’ names will be a record of the kind and nature of the errors that were made by them.

Resources available to staff during the change pilot

  • Posters
  • Journals
  • Checklists
  • Scholarly articles, including previous research
  • Flashcards

Meetings of certain stakeholders throughout the trial

There will be a weekly meeting for all of the stakeholders involved to review the efficacy of the initiatives and make any required adjustments if necessary.


Reporting the outcomes of the trial

Reporting of results will be through frequency tables. It will aid in the identification of the variations between before and after the intervention is delivered, if any.

The next steps for the use of the change process information

The information gathered will provide a better understanding of whether the newly implemented measures have had a good impact on decreasing medication mistakes in the healthcare facility. The information will provide insights into possible methods to enhance the intervention as a result of the information.

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