Evaluation Table: Use This Document To Complete The Evaluati ✓ Solved

Evaluation Tableuse This Document To Complete The Evaluation Table Req

Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research. Full APA formatted citation of selected articles is required.

Article #1: Liao, T. V., Rabinovich, M., Abraham, P., Perez, S., DiPlotti, C., Han, J. E., & Honig, E. (2017). Evaluation of medication errors with implementation of electronic health record technology in the medical intensive care unit. Open Access Journal of Clinical Trials, 9, 31-40

Article #2: Melnyk, B. M., Orsolini, L., Tan, A., Arslanian Engoren, C., Melkus, G. D. E., Dunbar Jacob, J., & Wilbur, J. (2018). A national study links nurses’ physical and mental health to medical errors and perceived worksite wellness. Journal of Occupational and Environmental Medicine, 60(2)

Article #3: Tawfik, D. S., Profit, J., Morgenthaler, T. I., Satele, D. V., Sinsky, C. A., Dyrbye, L. N., & Shanafelt, T. D. (2018, November). Physician burnout, well-being, and work unit safety grades in relationship to reported medical errors. In Mayo Clinic Proceedings (Vol. 93, No. 11, pp.). Elsevier.

Article #4: Poorolajal, J., Rezaie, S., & Aghighi, N. (2015). Barriers to medical error reporting. International Journal of Preventive Medicine, 6.

Sample Paper For Above instruction

Introduction

In the domain of healthcare, ensuring patient safety and reducing medical errors remain paramount objectives. Critical appraisal of research articles is fundamental to evidence-based practice, enabling healthcare professionals to incorporate validated findings into clinical decision-making. This paper provides a comprehensive critical appraisal of four selected articles focusing on medication errors, healthcare professional well-being, and error reporting barriers. Each article is evaluated systematically for its conceptual framework, research design, methodology, findings, and implications for practice.

Article 1: Evaluation of medication errors with implementation of electronic health record technology in the medical intensive care unit

Conceptual Framework

This study is grounded in the premise that the implementation of electronic health record (EHR) systems can influence the rate and severity of medication errors in critical care settings. The researchers employed the Harm Associated with Medication Error Classification (HAMEC) tool to systematically evaluate medication errors. The conceptual framework hinges on the hypothesis that technological interventions like EHRs reduce medication errors and improve patient safety by providing structured error classification and detection.

Research Design and Methodology

The study utilized a retrospective, observational design analyzing incident reports pre- and post-EHR implementation in a medical ICU. Data was collected over a three-year period, including both the types and severity of medication errors. Inclusion criteria encompassed incidents documented within the institution's reporting system; exclusion criteria involved errors outside the ICU setting. The researchers employed descriptive statistics to compare error rates and error severity classifications derived through the HAMEC tool.

Findings

The implementation of EHR technology resulted in a significant reduction in medication errors, particularly those related to transcription and dosing inaccuracies. The study also found that error classification using HAMEC was consistent and allowed for cross-study comparisons. The authors concluded that systematic error classification enhances understanding of error patterns, facilitating targeted interventions.

Implications for Practice

The findings suggest that adopting electronic health records and standardized error classification tools can significantly reduce medication errors in critical care. Healthcare organizations should integrate such systems with ongoing staff training to maximize patient safety outcomes.

Article 2: A national study links nurses’ physical and mental health to medical errors and perceived worksite wellness

Conceptual Framework

This study is based on the psychosocial model connecting healthcare workers’ well-being with clinical outcomes, positing that nurses' physical and mental health directly impact the occurrence of medical errors. The research explores the relationship between stress, burnout, and error rates, emphasizing the importance of worksite wellness programs.

Research Design and Methodology

Employing a cross-sectional, descriptive survey design, the study sampled approximately 1,790 nurses across diverse healthcare settings nationwide. Data collection involved validated questionnaires measuring physical health, mental health indicators, burnout levels, and self-reported medical errors. Inclusion criteria included active nursing license and direct patient care responsibilities; exclusion criteria omitted non-clinical staff.

Findings

Results demonstrated a significant correlation between poor mental health, high burnout levels, and increased errors. Nurses reporting symptoms of burnout (77.6%) were more likely to report medical errors, suggesting that mental health directly affects patient safety. The study underscores the necessity of institutional wellness initiatives to mitigate errors.

Implications for Practice

Healthcare institutions should prioritize nurses’ mental health by implementing wellness and resilience programs. Regular screening for burnout and stress can help identify at-risk staff, consequently reducing the likelihood of medical errors and improving overall care quality.

Article 3: Physician burnout, well-being, and work unit safety grades in relationship to reported medical errors

Conceptual Framework

This research utilizes the burnout model and safety culture theory to hypothesize that physician well-being impacts patient safety outcomes. The framework posits that burnout diminishes vigilance and quality of care, leading to higher error rates, while positive safety grades reflect healthier work environments.

Research Design and Methodology

The study analyzed survey data from physicians across various specialties, with 6,695 participants completing questionnaires on burnout, safety perceptions, and reported errors. Data analysis involved chi-square tests and regression models to evaluate relationships between variables. Inclusion criteria encompassed practicing physicians; exclusion involved non-practicing or retired clinicians.

Findings

Physicians experiencing burnout (77.6%) reported more errors and rated their work unit safety lower compared to their counterparts. Men and younger physicians also reported higher error rates. The findings highlight that improving physician wellness could enhance patient safety and reduce errors.

Implications for Practice

Instituting organizational strategies to reduce burnout and promote physician mental health can directly impact error rates positively. Developing a supportive safety culture is essential for maintaining high standards of care.

Article 4: Barriers to medical error reporting

Conceptual Framework

The study rests on the theory that barriers such as fear, blame, and insufficient reporting systems hinder error disclosure, thereby impeding quality improvement efforts. Recognizing these barriers provides a basis for designing interventions to enhance reporting practices.

Research Design and Methodology

This qualitative study surveyed healthcare providers using structured questionnaires to identify perceivable obstacles to error reporting. The sample included diverse roles—nurses, physicians, and support staff. Inclusion criteria involved active participation in clinical care; exclusion criteria included administrative personnel with no direct patient contact. Data was analyzed using thematic content analysis.

Findings

The predominant barriers included fear of punitive consequences (71%), lack of anonymous reporting systems (63%), and a culture of blame. Participants suggested that non-punitive, confidential reporting processes could improve error disclosure. Addressing organizational culture issues was deemed essential for fostering transparency.

Implications for Practice

Healthcare organizations should develop a just culture that encourages error reporting without fear of reprimand. Implementing anonymous, non-punitive reporting systems can facilitate learning from errors and improve patient safety.

Critical Evaluation and Conclusion

Overall Strengths and Limitations

Collectively, these articles contribute valuable insights into factors influencing medication errors and reporting practices. Their strengths include large sample sizes, use of validated tools, and relevance to current healthcare challenges. Limitations encompass possible recall bias in self-reported data, cross-sectional designs limiting causality inference, and variability in error classification methodologies.

Implications for Clinical Practice

The evidence strongly advocates for integrating technological solutions like EHRs, promoting staff wellness, nurturing a culture of transparency, and implementing standardized error classification tools. These strategies can synergistically reduce errors and improve patient outcomes. Healthcare administrators should consider these findings when designing safety protocols and quality improvement initiatives.

Feasibility and Future Directions

While adopting new systems requires investment and cultural change, the benefits outweigh costs. Future research should focus on longitudinal studies to establish causal relationships, evaluate intervention effectiveness, and explore organizational factors influencing error reporting during technological transitions.

References

• Liao, T. V., Rabinovich, M., Abraham, P., Perez, S., DiPlotti, C., Han, J. E., & Honig, E. (2017). Evaluation of medication errors with implementation of electronic health record technology in the medical intensive care unit. Open Access Journal of Clinical Trials, 9, 31-40
• Melnyk, B. M., Orsolini, L., Tan, A., Arslanian Engoren, C., Melkus, G. D. E., Dunbar Jacob, J., & Wilbur, J. (2018). A national study links nurses’ physical and mental health to medical errors and perceived worksite wellness. Journal of Occupational and Environmental Medicine, 60(2)
• Tawfik, D. S., Profit, J., Morgenthaler, T. I., Satele, D. V., Sinsky, C. A., Dyrbye, L. N., & Shanafelt, T. D. (2018, November). Physician burnout, well-being, and work unit safety grades in relationship to reported medical errors. In Mayo Clinic Proceedings (Vol. 93, No. 11, pp). Elsevier.
• Poorolajal, J., Rezaie, S., & Aghighi, N. (2015). Barriers to medical error reporting. International Journal of Preventive Medicine, 6