Medication administration errors are a healthcare concern and efforts to prevent and reduce their occurrence can leverage on different interventions that include the use of health information technology (HIT). The susceptibility to medication administration errors (MAEs) among the critically-ill patients is higher than other population or patient demographics (Trimble et al., 2017). Therefore, this EBP project will assess the effectiveness of implementing health information technologies compared to the conventional medication management processes to reduce medication errors among the critically-ill patients.
I think spiritual values do influence the decision to maintain academic integrity because otherwise, it would be hypocrisy. If one claims to be a spiritual being but cheats their way through life, then the question becomes who do we actually think we’re fooling? It is necessary to stay true to oneself and to choose the proper thing to do even when no one’s looking, to me, that’s the true definition of integrity. I also believe one must constantly work at or renew their spiritual beliefs because we’re all human without perfection so, at times will’s get weak and we envision success by taking the easier way out such as cheating on a test or taking credit where it isn’t due by putting our names on others’ work, committing infractions known to us as plagiarism but causing greater damage to the soul. We must remember every good thing worth having requires putting in the work required to achieve those goals. The constant struggle within to always do the right thing is understandable but, if we nourish the positivity more than we nourish the negativity, making the appropriate decisions become second nature and the struggle to make the desirable choices are lessened. It’s a greater sense of appreciation to know the goals achieved were achieved honestly and through hard work. When one puts in honest work, the process is respected!
| PICOT Question |
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| P |
Population |
Among the critically ill patients |
| I |
Intervention |
Integration of health information technology in the medication administration process |
| C |
Comparison |
Use of conventional or normal medication administration process |
| O |
Outcome |
Reduction n medication administration errors |
| T |
Timeframe |
Duration of hospital stay |
| PICOT
Create a complete PICOT statement. |
Among the critically ill patients (P), does the integration of health information technology (I) compared to conventional medication administration process (C), lead to a reduction in medication administration errors (O) during patient’s stay (T)? |
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| Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
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Medication administration errors are a health concern because of the adverse effects that they cause to patients and the need for healthcare providers, especially nurses, to develop interventions based on the use of evidence-based practice. Medication errors lowers quality care and patient outcomes. Medication errrs sometimes cause no harm to patients. However, in most cases, they devastate nurses and are harmful to patients. Nurses are a critical part of the care provision and have a duty to protect patients against errors in the medication administration process. The critically ill patients require close and effective monitoring and nurses remain accountable to anything that happens to the patients (Alotaibi & Federico, 2017). Interventions like the use of health information technology can enhance quality care outcomes and allow nurses to offer the most effective care to patients in critical conditions that include intensive care unit (ICU) (Naidu & Alicia, 2019). Health information technology enhances and transforms healthcare delivery as it leads to a reduction of human errors, facilitates better coordination among the interdisciplinary teams and improves overall practice efficiencies. By using health information technology models like electronic medication administration (e-MAR, barcode scanning and e-prescribing, stakeholders can reduce medication administration errors among nurses and enhance patient safety. |
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References
Alotaibi, Y. K. & Federico, F. (2017). The impact of health information technology on patient safety. Saudi
Medical Journal, 38(12):1173-1180. doi: 10.15537/smj.2017.12.20631
Naidu, M. and Alicia, Y.L.Y. (2019). Impact of Bar-Code Medication Administration and
Electronic Medication Administration Record System in Clinical Practice for an Effective Medication Administration Process. Health, 11, 511-526. https://doi.org/10.4236/health.2019.115044
Trimble, A. N., Bishop, B., & Rampe, N. (2017). Medication errors associated with transition from insulin pens
to insulin vials. American Journal of Health-System Pharmacy, 74(2), 70-75. doi:10.2146/ajhp150726
Week 1 Discussion
DQ1 Based on the PICOT you developed for NUR-550, summarize the change initiative you will be proposing. How does this support the population of focus, your setting, and role? Justify how the problem you selected to investigate is amenable to a research-based intervention using the PICOT format.
DQ2 Discuss the role of EBP in your specialty area of practice. Compare and contrast the role and implementation of EBP in your specialty with another advanced registered nurse specialty.
NUR590 Evidence Based Practice Project
Week 2 Discussion
DQ1 Do you foresee any issues with implementation of your project? Identify stakeholders who could assist in supporting you, and any theoretical frameworks (organizational change, leadership, role-specific) or models that could help you adapt.
DQ2 What strategies will you use in your new practice as an advance registered nurse to review and critique literature pertinent to your practice?
NUR590 Evidence Based Practice Project
Week 3 Discussion
DQ1 What levels of evidence are present in relation to research and practice, and why are they important regardless of the method you use?
DQ2 What factors must be assessed when critically appraising quantitative studies (e.g., validity, reliability, and applicability)? Which is the most important? Why?
NUR590 Evidence Based Practice Project
Week 4 Discussion
DQ1 What are some of the obstacles or barriers to implementing EBP in nursing? Provide a rationale for your answer. Since there are numerous topics on the issue, it is not appropriate to repeat one that has already been mentioned unless providing new information.
DQ2 Ensuring the protection of human subjects is necessary when conducting research projects. What are some methods that can be used to protect personal rights of someone in one of the groups that is labeled as vulnerable? Consider how a patient’s values and your own clinical judgment must be considered before applying the evidence in clinical decision making for an individual patient.
NUR590 Evidence Based Practice Project
Week 5 Discussion
DQ1 Identify the components of implementing your evidence-based practice project. What has been the most difficult component, and why? What do you think has gone well? Provide one piece of advice you would give to a colleague about the implementation process.
DQ2 Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project. This could range from support of the evidence-based project proposal to communication gaps. How could you address these problems?
NUR590 Evidence Based Practice Project
Week 6 Discussion
DQ1 When reviewing the literature and different types of evidence for your project, what gaps in the findings did you encounter? How could these gaps influence other researchers?
DQ2 What is the difference between statistically significant evidence and clinically significant evidence? How would each of these findings be used to advance an evidenced-based practice project?
NUR590 Evidence Based Practice Project
Week 7 Discussion
DQ1 Identify the audience for your EBP proposal and discuss strategies for disseminating the proposal.
DQ2 How will you ensure that all appropriate audiences receive information about research and EBP initiatives?
NUR590 Evidence Based Practice Project
Week 8 Discussion
DQ1 Post a rough draft of your “Evidence-Based Practice Presentation.” The purpose of this draft is to get feedback from your peers. Identify at least two areas you would like specific feedback for improvement.
Peers are encouraged to also comment on anything they feel is successful or could be further improved. Review all of the presentations, but provide critical commentary for at least one other posted presentation.
DQ2 The EBP process is a powerful way of advancing improvements in health care. Identify three strategies that you will now incorporate into your practice based on this course. Explain your rationale.
Successful implementation of evidence-based practice projects is important for organizational success. Organizational factors such as support from leadership and management are the critical determinants for the successful implementation of evidence-based practice projects. Therefore, this paper is an examination of the organizational readiness and culture assessment to determine its ability to support the proposed change. The second section is a review of literature to refine the PICOT of the project.
Part A
The organizational readiness assessment was done using a tool developed by Buldingmovement.org. The tool examines the level of readiness as well as culture of health organizations in relation to the implementation of evidence-based practice interventions. The tool examines different organizational aspects that include vision, mission and goals, leadership and governance and staff. The assessment results showed that the hospital is ready to implement the proposed change. The readiness could be seen from the staffs scoring most of the responses in the assessment tool as either true or developing or in process. The assessment areas that had the highest scores in the tool included vision, mission and goals and staff sections. The high scores in the vision, mission and goals section were seen in the statements that included the organization having a written vision statement that staff, leadership and board understand and guides the organizational tasks. High scores were also seen in the statement about the mission statement being written in the organization and staffs, leaders, managers and board understand it, as it guides their actions. The statements that had the highest scores in the staff section included staffs being well-informed about the needs of those they serve, seeking contributions from others and expressing their awareness about the needs of others (Buildingmovement.org, n.d.).
The organization scored poorly in the leadership and governance section. The poor score in this section led to the identification of organizational weaknesses and possible barriers such as leadership and governance not be informed about the needs of the staffs and other stakeholders, not seeking input and contribution from others and not being adequately open for new ideas. Based on this, the organization seeks to address the weakness by introducing new leadership styles that emphasis stakeholder involvement and prioritization of their needs in strategy development. Therefore, clinical inquiry will be incorporated into the organization by creating a culture that supports continuous learning, innovation and focusing on organizational strengths and opportunities to minimize barriers and weaknesses.
Part B
Diabetes mellitus is a prevalent problem affecting the majority of African American populations. According to Mitchell et al., (2020), African Americans experience a disproportionate high rate of diabetes mellitus type 2 than non-Hispanic whites in America. African Americans are two times highly likely to be affected by diabetes when compared to non-Hispanic whites in the state (Mitchell et al., 2020). Diabetes mellitus type 2 is highly associated with modifiable and non-modifiable risk factors that include smoking, physical inactivity, alcohol consumption, poor dietary habits and genetics (Joseph et al., 2017). The health risks of diabetes such as diabetic foot, diabetic ketoacidosis and hypoglycemia can be managed and prevented effectively using community-based interventions such as nutritional education and physical activity. According to Soltero et al., (2018), community-based diabetes prevention intervention led to an improvement in insulin sensitivity, weight specific quality of life and reduction in the BMI among youths that were obese and at risk of diabetes. A systematic review performed by Shirinzadeh et al., (2019) showed that the use of community-based nutrition and physical activity programs were associated with a significant reduction in the risk of developing diabetes. There was also a significant reduction in body mass index, weight and weight circumference in the participants in the intervention groups (Shirinzadeh et al., 2019). Similar outcomes can be seen in the studies by Maheri et al., (2017) and Smith et al., (2019). Therefore, based on the results of the review, the refined PICOT statement is as follows:
In African American patients with diabetes, does the use of community-based programs that focus on physical activity and nutritional interventions result in improvement in treatment outcomes and complications when compared to no use within a period of six months?
Conclusion
Overall, the readiness assessment showed that our hospital is ready to implement the proposed evidence-based practice project. A focus will be placed on the strengths of the organization and its opportunities to minimize the effects of threats and weaknesses that it has. The review of literature supports the use of community-based interventions to improve the treatment outcomes in diabetes mellitus type 2. Therefore, it is anticipated that the organization will support the implementation of the project.
References
Buildingmovement.org. (n.d.). Organizational Readiness Assessment. Retrieved from http://www.buildingmovement.org/wp-content/uploads/2020/03/Organizational_Readiness_Assessment_Tool.pdf
Joseph, J. J., Echouffo-Tcheugui, J. B., Talegawkar, S. A., Effoe, V. S., Okhomina, V., Carnethon, M. R., Hsueh, W. A., & Golden, S. H. (2017). Modifiable Lifestyle Risk Factors and Incident Diabetes in African Americans. American Journal of Preventive Medicine, 53(5), e165–e174. https://doi.org/10.1016/j.amepre.2017.06.018
Maheri, A., Asnaashari, M., Joveini, H., Tol, A., Firouzian, A. A., & Rohban, A. (2017). The impact of educational intervention on physical activity, nutrition and laboratory parameters in type II diabetic patients. Electronic Physician, 9(4), 4207–4214. https://doi.org/10.19082/4207
Mitchell, F. M., Sangalang, C., Lechuga-Peña, S., Lopez, K., & Beccera, D. (2020). Health Inequities in Historical Context: A Critical Race Theory Analysis of Diabetes among African Americans and American Indians. Race and Social Problems, 12(4), 289–299. https://doi.org/10.1007/s12552-020-09301-4
Shirinzadeh, M., Afshin-Pour, B., Angeles, R., Gaber, J., & Agarwal, G. (2019). The effect of community-based programs on diabetes prevention in low- and middle-income countries: A systematic review and meta-analysis. Globalization and Health, 15(1), 10. https://doi.org/10.1186/s12992-019-0451-4
Smith, J. R., Greaves, C. J., Thompson, J. L., Taylor, R. S., Jones, M., Armstrong, R., Moorlock, S., Griffin, A., Solomon-Moore, E., Biddle, M. S. Y., Price, L., & Abraham, C. (2019). The community-based prevention of diabetes (ComPoD) study: A randomised, waiting list controlled trial of a voluntary sector-led diabetes prevention programme. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 112. https://doi.org/10.1186/s12966-019-0877-3
Soltero, E. G., Olson, M. L., Williams, A. N., Konopken, Y. P., Castro, F. G., Arcoleo, K. J., Keller, C. S., Patrick, D. L., Ayers, S. L., Barraza, E., & Shaibi, G. Q. (2018). Effects of a Community-Based Diabetes Prevention Program for Latino Youth with Obesity: A Randomized Controlled Trial. Obesity, 26(12), 1856–1865. https://doi.org/10.1002/oby.22300
