The article by Verweij et al. (2014) is devoted to the research of the effectiveness of drug round tabards with respect to reducing the cases of nurse interruptions and medication administration errors. Here, the results of the study will be considered in the light of the limitations, and possible conclusions and implications will be proposed. Thus, the present paper involves considering the steps three and six of the process of research outcomes interpreting as presented by Grove, Burns, and Gray (2013, p. 590).
Conclusions and Limitations
Verweij et al. (2014) observed 313 medical administrations in three wards in a Dutch university hospital. They admit that the limitations of the work include the possible observer errors, which they tried to reduce with the help of training, and the low occupancy of beds in some of the wards during certain periods of the study. A similar investigation was conducted by Scott, Williams, Ingram, and Mackenzie (2010), but its authors explicitly stated that additional research was required since their work did not provide sufficient understanding of the tabards’ effectiveness. Still, the results of the two studies comparably indicate that the intervention is effective, and the following conclusions can be drawn from the work by Verweij et al. (2014).
The study by Verweij et al. (2014) proved that tabards are an effective intervention that reduces the cases of nurse interruption and medication errors during the drug round. However, the study was also aimed at understanding the reasons for this effectiveness. In this respect, it can be concluded that the effectiveness of the intervention may depend on the nurses’ and patients’ perceptions and the qualities of the tabards themselves. From the point of view of the nurses, a negative attitude (regarding the usefulness, patient perception, or personal issues concerning the tabards) can prevent them from using the tabards at all. This fact brings along the matter of the qualities of tabards: nurses may be against putting them on if they are not personal and if their color appears to attract too much attention or has the potential of driving patients away. Also, the authors found that patient-caused interruptions were relatively unaffected by tabards. The limitation of bed occupancy should be considered in this respect. However, the nurses also indicated that their colleagues had been the primary source of interruption before the intervention and after it; besides, most of them are opposed to the idea of not paying attention to a patient. These basic conclusions do not provide an exhaustive explanation of the effectiveness of tabards, but they suggest an insight into it.
Finally, it is noteworthy that the effect on medication administration errors is smaller than that on the interruptions, although it is still impressive (66%). This fact demonstrates that errors are likely to be caused by other aspects that are not related to interruptions and suggests future exploration of the issue, which is an implication for future research.
Implications for Clinical Practice
The study has several implications for hospitals and nurses involved in medication distribution. For the hospitals, the study demonstrates that the implementation of drug round tabards is worthy of attention, and it is the administration’s job to start the process. For nurses, the study demonstrates that wearing tabards can sufficiently improve their work, which implies that they should be more open to the idea. This implication is especially significant since, as shown by Verweij et al. (2014) and Scott et al. (2010), some of the nurses need the proof of the effectiveness of tabards to agree to wear them. However, if they experience some negative considerations, they might want to share them with other nurses and the administration, which may lead to the improvement of the practice. An example of such improvement is the discussion of the color and the cleaning procedures from the study. Concerning the patients, the study implies that nurses might need to educate them on the purpose of tabards to reduce the occurrence of interruptions. However, it is apparent that if the nurse’s help is necessary, they are likely to be willingly distracted in any case.
References
Grove, S. K., Burns, N., & Gray, J. R. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th ed.). St. Louis, MS: Elsevier.
Scott, J., Williams, D., Ingram, J., & Mackenzie, F. (2010). The effectiveness of drug round tabards in reducing incidence of medication errors. Nursing Times, 106(34), 13–15.
Verweij, L., Smeulers, M., Maaskant, J., & Vermeulen, H. (2014). Quiet Please! Drug Round Tabards: Are They Effective and Accepted? A Mixed Method Study. Journal Of Nursing Scholarship, 46(5), 340-348. Web.