Benchmark – Evidence-Based Practice Project: PICOT Paper

NUR 550 Benchmark – Evidence-Based Practice Project: PICOT Paper

Benchmark – Evidence-Based Practice Project: PICOT Paper

The need for increased patient safety and quality care implores healthcare providers, especially nurses, to develop evidence-based practice interventions using translational research to prevent and reduce medication administration errors (MAEs). Medication administration errors are a serious safety concern and the use of best practices like application of health information technology approaches can prevent and reduce their occurrence and prevalence in health care settings (Alotaibi & Federico, 2017). The purpose of this assignment is to describe the PICOT developed for the evidence-based practice (EBP) project that entails the use of health information technology by healthcare workers to reduce and prevent the occurrence of medication administration errors among critically-ill patients.

Population’s Demographics and Health Concerns

The critically-ill patients require close monitoring and use different types of medications to ensure that their conditions are stable. Healthcare workers, particularly nurses, commit medication administration n errors (MAEs) that threaten patient safety and quality care delivery. MAEs are a health concern due to the adverse effects that they cause to patients and the need for providers to implement evidence-based practice interventions to address them (Jheeta & Franklin, 2017). These errors cause harm and sometimes not. However, in a majority of cases, they devastate patients and their families as they lead to increased duration of stay in hospitals, poor patient outcomes, and even adverse events like fatalities. Nurses are a crucial part of care provision and have a professional and ethical duty to protect patients against the adverse effects emanating from these errors to guarantee patient safety.

The critically-ill patients need keen monitoring and nurses should be accountable to anything that happens to the patients. They should implement interventions that lead to better protection and quality care delivery aimed at minimizing and preventing the possibility of the errors from happening. Close monitoring requires effective deployment of technology like the use of health information technologies to enhance care delivery.

Proposed Evidence-Based Intervention

The integration of health information technology (HIT) is essential in reducing and preventing the occurrence of medication administration errors. Health information technology improves and transforms healthcare delivery because of the convenience it provides in responding to distress calls by patients. By utilizing interventions like electronic medication administration, barcode scanning and e-prescribing, healthcare workers and other stakeholders can mitigate medication administration errors that may affect critically-ill patients. In their study, Jeffries et al. (2017) observe that monitoring of possible hazardous prescribing is essential in enhancing medications safety. The authors deploy different qualitative realistic evaluation approaches to assess the effects of implementing and adopting use of health information technology models like an electronic medicines optimization system. The findings suggest that health information models improve patient safety by reducing and preventing errors through reviewing patients at risk of adverse drug events.

In their study, Lapkin et al. (2017) evaluate the effectiveness or interventions meant to reduce medication administration errors by synthesizing findings using systematic reviews. The authors suggest that using multifaceted approaches entailing the application of education and risk management strategies alongside barcode technology helps in reducing and preventing medication administration errors. These interventions demonstrate the need to integration other components like double-checking and the effects of interruptions and self-administration. As such, the study shows that despite challenges that may arise in the medication administration process, health information technology interventions like barcoding mitigates the occurrence of errors.

Comparison with Previous Practices

The need to enhance patient safety and quality of care remains a critical aspect of integrating health information technology to reduce

Benchmark - Evidence-Based Practice Project PICOT Paper
Benchmark – Evidence-Based Practice Project PICOT Paper

and prevent medication errors. In their study, Yogini et al. (2020) assert that errors in medication administration are prevalent and there are many interventions that can help to reduce their occurrence. The study shows that previous practices of not incorporating health information technology have led to serious effects on patient safety and even providers. Another study by Gait et al. (2019) discusses the use of health information technology as compared to previous practices among pharmacists in efforts to reduce medication errors. The authors identify practices like workload, insufficient integration of technology, and disruptive work environment that make it difficult for pharmacists to have accurate prescription and administration of medications. The lack of effective vigilance and close monitoring are previous practices attributed to increased incidences of medication administration errors. Therefore, it is important for providers to implement interventions that will enhance safety of patients and increase the quality of care outcomes. Health information technology integration remains a core aspect of addressing the problem and ensuring that patients are not harmed and providers do not register errors or near misses in the medication process.

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Expected Outcomes of the Intervention

At the core of this intervention is to reduce and prevent the occurrence and prevalence of medication administration errors and enhance overall patient safety. The integration of health information technology will result in significant quality and safety outcomes for patients and their healthcare providers. Healthcare workers need to appreciate the significance of HIT as a way of helping them address factors associated with medication administration errors like workload and near misses caused by human weaknesses. The use of health information technology models like barcode scanning will enhance adherence and compliance to evidence-based practice approaches and enable facilities and healthcare workers to address medication process errors.

Period for the Implementation

The intervention will be executed for the duration that critically-ill patients are in hospitals; which implies that medication administration process is not a one-off issue but requires continual adherence and compliance to existing interventions. However, an initial implementation period will focus on the first five days of a patient’s admission or in proportion to the number of days that one will stay in a facility getting medications.

Nursing Science, Social Determinants of Health, Epidemiologic, Genomic and Genetic Data

The chosen population include critically-ill patients and healthcare workers and how both can work to reduce and prevent medication administration errors. Healthcare workers, especially nurses, need to understand the genomic effect of medication errors on patients and integrate evidence-based practice interventions that include health information technology (Ahonen et al., 2018). Critically-ill patients may experience adverse events that may lead to mortality based on their genomic and genetic interactions from medications.

Social determinants of health impact access to health care and use of health information technology among the critically-ill patients. Nurses have training on the best way to integrate these technologies to enhance patient safety. They should focus on health promotion, and prevention of medication administration errors that impact patient safety.


Medication administration errors impact patient safety and quality of care for patients. The implication is that using health information technology like barcode scanning and smart devices as well as other interventions can prevent their occurrence. Nurses and other healthcare workers should understand that critically-ill patients require effective monitoring to reduce the occurrence of medication administration errors.


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population health inequities research and prevention. American journal of public health, 108(3), 306-311. doi: 10.2105/AJPH.2017.304214.

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient

safety. Saudi medical journal, 38(12), 1173. doi: 10.15537/smj.2017.12.20631

Galt, K. A., Fuji, K. T., Kaufman, T. K., & Shah, S. R. (2019). Health information technology

use and patient safety: study of pharmacists in Nebraska. Pharmacy, 7(1), 7.

Jani, Y., Chumbley, G. M., Furniss, D., Blandford, A., & Franklin, B. (2020). The potential role

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Jeffries, M., Phipps, D. L., Howard, R. L., Avery, A. J., Rodgers, S., & Ashcroft, D. M. (2017).

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Jheeta, S. & Franklin, B. D. (2017). The impact of a hospital electronic prescribing and

medication administration system on medication administration safety: an observational study. BMC Health Services Research, 17(547).

Lapkin, S., Levett‐Jones, T., Chenoweth, L., & Johnson, M. (2017). The effectiveness of

interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews. Journal of nursing management, 24(7), 845-858. DOI:10.1111/jonm.12390

Trauma occurs when individuals are overwhelmed by circumstances or events and counters them with extreme horror, fear, and helplessness. Excessive stress overwhelms an individual’s coping capacity. Trauma can stem from exposure to abuse, discrimination, neglect, violence, and accidents (Shalaby & Agyapong, 2020). This paper seeks to describe populations with traumatic experiences and an intervention to address the concern and discuss factors that influence health management.

Population’s Demographics and Health Concerns

According to the National Council for Behavioral Health (NCBH), 70% of adults in the U.S. have experienced a traumatic event at least once. Almost all children who observe a parental homicide or sexual assault will develop Post Traumatic Stress Disorder (PTSD). Likewise, 90% of sexually abused children, 77% who school shootings, and 35% of youths exposed to community violence develop PTSD (NCBH, 2020). Trauma is associated with adverse effects on physical and mental health as well as social and occupational functioning.  Physical effects include headaches, excessive sweating, palpitations, altered bowel patterns, and being easily startled. Mental impact includes fear, anxiety, depression, emotional swings, increased alcohol and drug use, and sleeping difficulties (Mikhail et al., 2018). Furthermore, individuals socially isolate themselves due and have diminished interest in activities.

Proposed Evidence-Based Intervention

The proposed intervention incorporates peer support in trauma-informed care to accelerate the recovery process.  Peer support involves having persons from diverse backgrounds sharing common trauma experiences (Shalaby & Agyapong, 2020). The intervention uses peer support workers, individuals with lived trauma experiences, and who have received special training to be part of the care team. Based on their similar experiences and the shared understanding, patients may trust their peer support worker and be more willing to engage in treatment.

Incorporating peer support supports Healthy People 2020 goal of improving mental health through prevention and ensuring access to appropriate, quality mental health services. The intervention will improve the mental health outcomes of persons with trauma experiences. It will help prevent mental health issues such as anxiety, PTSD, depression, and alcohol and substance use disorders.

Comparison of the Intervention to Previous Practice or Research

Previous practice in trauma-informed care entailed using behavioral health counselors. Crisanti et al. (2019) compared cognitive behavioral therapy intervention groups guided by certified peer support workers with groups led by behavioral health counselors for trauma survivors with PTSD. At six months after baseline, persons in the peer-led sessions had a higher therapeutic alliance and stronger connection than those in the counselor-led sessions. The study shows that peer support can increase patient engagement and ultimately accelerate the recovery process.

Expected Outcome for the Intervention

Incorporating peer support is expected to increase patients’ engagement in treatment and thus accelerating their recovery. Since patients will share their trauma experiences with peer support workers who have experienced similar experiences, it will promote a shared understanding and increase patients’ trust (Shalaby & Agyapong, 2020). Peer support is expected to help patients overcome social isolation caused by trust issues by creating trust between patients and the peer workers.

Time for Implementation and Evaluation of the Outcome

The intervention will be implemented within six months. Patients will be randomly assigned to an intervention or a control group. The intervention group will be assigned to a peer support worker, while the control group will be provided the usual trauma-informed care without peer support. Evaluation will be conducted six months after the implementation of the peer support care. The recovery scores of patients in the intervention group will be compared to those of the control group to evaluate the difference in recovery and outcomes.

Synthesis of Nursing Science, Determinants of Health, and Epidemiologic, Genomic, and Genetic Data in the Management of Population Health

Nursing science is applied to support patients with trauma experiences in line with the principles of safety, respect, and trust. Nursing science is also applied in delivering patient-centered care to improve patient engagement and the quality of trauma-informed care (Fleishman et al., 2019). Social determinants such as living in under-resourced or racially segregated neighborhoods and experiencing food insecurity can result in toxic stress.  Social determinants that should be considered in trauma screening include poverty, neighborhood crime and violence, and racism (Mikhail et al., 2018). Health providers should increase protective factors to mitigate exposure to trauma and environmental factors that contribute to it.

Trauma mainly affects minority racial groups, children, adolescents, and older adults.  The data can be applied in trauma-informed care by emphasizing screening for trauma experiences among high-risk populations. Youssef et al. (2018) found that trauma exposure can be passed to offspring transgenerationally via the epigenetic inheritance mechanism of DNA methylation alterations. The genetic data can be synthesized in trauma-informed care by emphasizing trauma screening to persons whose close relatives were exposed to trauma.


More than 70% of the U.S population has encountered traumatic events such as homicide, sexual assault, shooting, and community violence. Trauma is associated with adverse effects on physical and mental health and impairments in social and occupational functioning. My proposed intervention is to incorporate peer support in trauma-informed care. Peers work together with patients to create relationships where they share their strengths and support each other’s healing. Peer support is expected to increase patient engagement and accelerate recovery. The intervention will be implemented over six months using an intervention and control group.


Crisanti, A., Murray-Krezan, C., & Reno, J. (2019). Are treatment groups led by peers as effective as groups led by counselors for treating posttraumatic stress disorder and substance use disorder?

Fleishman, J., Kamsky, H., & Sundborg, S. (2019). Trauma-informed nursing practice. OJIN: The Online Journal of Issues in Nursing24(2).

Mikhail, J. N., Nemeth, L. S., Mueller, M., Pope, C., & NeSmith, E. G. (2018). The social determinants of trauma: a trauma disparities scoping review and framework. Journal of Trauma Nursing| JTN25(5), 266-281.

National Council for Behavioral Health. (2020, July 17). Trauma Infographic. National Council.

Shalaby, R., & Agyapong, V. (2020). Peer support in mental health: Literature review. JMIR mental health7(6), e15572.

Youssef, N. A., Lockwood, L., Su, S., Hao, G., & Rutten, B. (2018). The Effects of Trauma, with or without PTSD, on the Transgenerational DNA Methylation Alterations in Human Offsprings. Brain sciences8(5), 83.