401208 Research for Nursing and Midwifery: Guided Review of Nominated literature Assessment 2 Answer
|Guided question||Qualitative study-- Smeulers, M., Onderwater, A.T., van Zwieten, M.C. and Vermeulen, H., 2014. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study. Journal of Nursing Management, 22(3), pp.276-285.||Quantitative study- Sahay, A., Hutchinson, M. and East, L., 2015. Exploring the influence of workplace supports and relationships on safe medication practice: A pilot study of Australian graduate nurses. Nurse education today, 35(5), pp.e21-e26.|
|1 . What was the aim and significance of the study||The aim of the study has been to explore the experiences of nurses from the perspective of preventing medication administration errors in healthcare settings.|
Research into medication administration errors in healthcare settings is significant because there is little knowledge about the complex issues associated with learning and development of the nursing skills and knowledge. Moreover, safe medication management helps in providing a healthy and professional environment for nurses to develop their skills. Necessary inputs can also be gained from the physicians and pharmacists to get a broader view of the necessity of safety in administering on the part of the nurses.
|The main aim of this study is to identify graduate self-reported medication errors. Further, the study aims to identify whether there is any relationship between medication errors and workplace support and behaviour of graduate nurses. The research, therefore, tends to establish the fact that whether there will be any medication errors if graduate nurses receive required level of support or it is only a human error due to the inexperience of graduate nurses.|
The main objective of the research is to investigate workplace supports and behaviour and its relationship with safe medication practices of graduate nurses.
|2a. The research design used in the study and was it appropriate for the issue discussed||The authors have selected the exploratory qualitative research design to conduct the study. It is an appropriate method as the intention was to obtain personal perspective of nurses and their experiences with medication safety and not to evaluate the department. |
The research is conducted in a familiar setting of health care and with an identified set of concerns related with medication errors. The aim of the study was to generate new ideas about reducing such errors and refining the issues to provide a direction for future research. These requirements makes exploratory research design most appropriate to conduct the study to gain an insight into what, why, and how of medication errors.
However, this research design limits the sample size thereby limiting the generalization of study results (Kim et al., 2017). At the same time the unstructured nature of exploratory research design makes the results tentative and gives conclusions that are not definitive resulting in lack of rigorous standards applied to data collection and analysis methodology (Ellenbecker, 2017).
|A descriptive quantitative analysis of a larger mixed methods study is given here and used as a methodology. This is the most appropriate study design because it allows observing the participants/subjects without influencing their responses and the topic of study can be studied only through this particular research design. |
Descriptive research design makes it possible to observe the participants in an unchanged environment and helps in identification of variables to be tested. The collection of data under this particular research design allows looking into detailed information leading to a multifaceted approach to data analysis. The benefit of collecting and studying a large amount of data makes it method/design appropriate for the study (Bradshaw et al., 2018).
However, many a times this research design is considered unreliable for non-manipulation of variables thereby making statistical analysis impossible.
At the same time, an exploratory research design was adopted which describe the methods and processes undertaken. It also enables the researcher to develop new processes to interpret the existing methods.
|2b. Sampling technique||Purposive sampling was done to maintain a high level of heterogeneity. Nursing ward managers, quality and safety innovators and nursing managers were contacted through emails by two researchers. Then the name of the other nurses was obtained from them through the snowball technique. The criteria for the nurses to be included in the research were that they have to be registered nurses.||A total of 58 graduate students from two different Australian states were taken as a sample to complete the research. The sampling method used was convenience sampling. Registered nurses were included in the research whereas those who do not fit in the description of registered nurse namely those who have not completed their nursing degree and have not completed their first 18-24 months of clinical practice are excluded from the research.|
|2c. Data collection method and its appropriateness||The intent of the study is to find a better analysing technique than what is being in use at present. Thus, creating a clear idea of the prevalent practices in use could rule out the possibility of committing similar mistakes during the research work. Hence the possibility is excluded through taking the survey about the safety measures. The required data was collected through qualitative semi-structured interviews with nurses who were contacted through email. In the email, the purpose of the interview was mentioned and explained comprehensively. The interview topics and questions were refined and narrowed in scope twice after conducting some initial interviews. |
The collection of data through semi-structured interviews is appropriate for a qualitative study. The current study is focused on exploring the experiences and perspective of nurses on medication errors and therefore a direct interaction help in getting accurate information (Peyrovi et al., 2016). At the same time a semi-structured interview allows two-way communication where informants get the freedom to express their views in their own terms (Bradshaw et al., 2018). It is a type of extension tool where interviewed can also ask questions from the interviewer while offering an opportunity to learn through answers and reasons given for the answers during the interview.
Moreover, narrowing of topic scope is always necessary to reach the targeted data and this became possible under the semi-structured interview method proving to be the suitable method under the selected research study.
|The data is collected from recent graduate nurses. The information was taken from three Australian university school of nursing databases from where a list of 1425 recent graduate nurses was found. |
Under descriptive research design, the survey method of data collection is used for describing phenomenon and summarizing them (Peyrovi et al., 2016). At the same time, surveys a prove to be effective in measuring association between things and therefore proved to be effective in investigating the relationship between workplace support and safe medication practice of graduate nurses.
Furthermore, the closed-ended questions and semantic differential questions defined under different categories like nature of medication and error reporting, nature of errors and erosion of safe medication practice help in determining the relationship between variables as well as identify the areas that needs improvement to reduce the number of medication errors (Abutabenjeh and Jardat, 2018).
|3a. Data analysed and was it appropriate for the study||Parallel with the interview process; data analysis was also performed according to the guidelines of the qualitative research and using MAXQDA10software (Boeije 2008, VERBI software 2010). After each interview, the interviews were independently coded and compared and discussed vehemently. For the first 15 interviews, a consensus was reached between the participating researchers. The rest of the five was distributed among the various researchers randomly. One of the authors coded while the other reviewed the interview process and the data collected from it. This method was deliberately adopted to maximise the authenticity and intention of the information provided.||The survey data was collected mainly from Qualtrics@online platform. The online platform was associated with the Australian university school of nursing. |
The collected data then analysed with the help of a statistical tool Statistic Package for Social Sciences (SPSS). The complete data set was analysed with the help of descriptive statistics which has helped in identifying missing data as well as logical responses. Further, Spreeman correlation, frequency analysis using mean and median were conducted.
It shows that the collected data was analysed appropriately using the statistical tools and is analysed from the different point of view to identify any bias in the responses, findings of the literature review and findings of the primary data (Abutabenjeh and Jardat, 2018).
|3b. Findings of the study||The points came out of the analysed data:|
The ability of the nurses to work safely daily. As they are the individuals who physically administer the medicines, it is of paramount importance to know how to do such work. They must state safety precautions every time and differently for each patient under their care. This minimises any potential risk. The study also helps in highlighting the roles and responsibilities of the nurses in medication safety. The study also helps in understanding the safety practices to be followed by the nurses in the health care settings.
|The research has found out that there is a high link between workplace support and medication errors. Young nurses especially those who have just come in the clinical practice are prone to higher risk of medication errors if they do not get support from the senior management and senior physicians. Nurses who receive support are unlikely to show any vulnerable behaviour which reduces the chance of medication error and ensures patient health and safety.|
|3c. Limitations and recommendations||This research was limited to a single centre study in a university hospital setting. This may affect the generalization of results that can be avoided by covering more than one heathcare setting and increasing the sample size of the study. In order to cover the large sample size it is recommended to apply open-ended questionnaire. |
However, the results are consistent with the other research studies and therefore, the findings can prove to be transferrable. Moreover, the results can have implications for other healthcare settings.
|The limitation of the research lies in the accessibility of recent graduates and not including nurses for whom a considerable period of ime had elapsed since graudation. Therefore the selection of participants may have influenced the respondents’ profile. |
Furthermore, the use of self-report and lack of information on non-responders is another limitation leading to bias as the sample may lack representation of the considered population for the study.
It is recommended that a bias in results should be avoided by using correlational research design and makes it possible to cover a large sample size.
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