Use This Document To Complete Part 2 Of The Module

Use this Document To Completepart 2of The Mod

Use this document to complete Part 2 of the Module 2 Assessment, Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies. Full citation of selected article. Describe the clinical issue of interest, how you developed a PICO(T) question, the research databases used, the citations, and the levels of evidence of your articles. Include explanations of the strengths of systematic reviews and how they support clinical research. Incorporate outside and course-specific resources that support your analysis.

Paper For Above instruction

The clinical issue of interest for this evidence-based project centers on nursing medical errors, a critical factor affecting patient safety and healthcare quality globally. Medical errors within nursing practice, including medication mistakes, omissions, and procedural errors, have been identified as significant contributors to adverse patient outcomes. Understanding the nature, prevalence, contributing factors, and strategies for prevention of these errors is essential for improving clinical care and patient safety metrics. Given the increasing complexity of healthcare environments, addressing this issue through robust research methodologies enables evidence-based interventions that can subsequently reduce medical errors, improve nursing practices, and enhance overall patient care.

The development of a PICO(T) question facilitated a focused exploration of this clinical issue. The Population (P) comprises registered nurses working in hospital settings; the Intervention (I) involves implementing targeted safety protocols and educational interventions; the Comparison (C) entails standard nursing practices without specialized safety protocols; and the Outcome (O) focuses on the reduction in medication errors and adverse events. The Timeline (T), if specified, would reflect the period during which the interventions are expected to influence outcomes, typically over six months to one year.

To gather relevant, high-quality evidence, four research databases were utilized: CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, MEDLINE via EBSCOhost, and the Cochrane Library. These databases are reputable sources for peer-reviewed articles related to nursing practices, healthcare outcomes, and clinical research. Through systematic searches using Boolean operators, MeSH terms, and keywords such as “nursing errors,” “patient safety,” “medication administration,” and “nurse staffing,” pertinent articles were identified and selected for review.

The four peer-reviewed articles selected exemplify different levels of evidence, including systematic reviews, observational studies, and quantitative research. Their citations are as follows:

1. Hessels, A. J., Paliwal, M., Weaver, S. H., Siddiqui, D., & Wurmser, T. A. (2019). Impact of patient safety culture on missed nursing care and adverse patient events. Journal of Nursing Care Quality, 34(4), 317–324. https://doi.org/10.1097/NCQ.0000000000000398

2. Fathi, A., Hajizadeh, M., Moradi, K., Zandian, H., Dezhkameh, M., Kazemzadeh, S., & Rezaei, S. (2017). Medication errors among nurses in teaching hospitals in the west of Iran: What we need to know about prevalence, types, and barriers to reporting. Epidemiology and Health, 39, e2017004. https://doi.org/10.4178/epih.e2017004

3. Griffiths, P., Ball, J., Bloor, K., Böhning, D., Briggs, J., Dall’Ora, C., ... & Meredith, P. (2018). Nurse staffing levels, missed vital signs, and mortality in hospitals: Retrospective longitudinal observational study. Health Services and Delivery Research, 6(38), 1–134.

4. Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., ... & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 17(1), 6-22. https://doi.org/10.1177/1474515117720227

The levels of evidence represented by these articles range from systematic reviews and meta-analyses to observational studies. Systematic reviews synthesize existing research by providing comprehensive analyses, which strengthen clinical decision-making by highlighting patterns, gaps, and robust findings across multiple studies. For example, Driscoll et al. (2018) conducted a systematic review and meta-analysis that synthesized data from numerous studies, providing high-level evidence on how nurse staffing ratios impact patient outcomes. Such research is essential because it reduces bias, improves reliability, and offers generalizable conclusions that inform policy and practice.

The strengths of systematic reviews in clinical research lie in their methodological rigor, comprehensive scope, and capability to aggregate large amounts of data, translating into more reliable recommendations for practice. They mitigate individual study limitations, enhance statistical power, and present a consolidated view of evidence, which is invaluable for guiding clinical protocols, policy-making, and future research directions. For example, the review by Driscoll et al. underscores how staffing ratios directly influence patient safety parameters, guiding hospital staffing policies widely adopted in healthcare systems.

The research methodologies employed among the selected articles vary. Hessels et al. (2019) used a cross-sectional survey approach to assess the impact of organizational culture on medication errors and adverse patient events, providing qualitative insights into the contextual factors influencing error reporting and safety practices. Their methodology allows for understanding perceptions, attitudes, and organizational influences, which are crucial for designing interventions.

Fathi et al. (2017) utilized a quantitative descriptive design through surveys to determine the prevalence and types of medication errors among nurses within Iranian teaching hospitals, along with barriers to reporting these errors. Their approach facilitates quantifying error rates and identifying systemic barriers, which is vital for developing targeted strategies to improve error reporting and patient safety culture.

Griffiths et al. (2018) employed retrospective longitudinal observational methods using existing hospital data to analyze the relationship among nurse staffing levels, missed vital signs, and mortality rates. This methodology enables the analysis of large datasets over time, revealing patterns and associations that support causal inferences regarding staffing and patient outcomes.

The strengths of these methodologies lie in their suitability for answering specific research questions. Cross-sectional surveys and descriptive studies are excellent for capturing perspectives and prevalence, while retrospective analyses leverage existing data to detect associations over time. Systematic reviews add the advantage of collectively evaluating multiple studies, thus providing a high level of evidence for clinical practice changes.

Reliability and validity in these methodologies depend largely on proper sampling, data collection techniques, and analysis procedures. For example, the use of validated questionnaires and statistical tools in Fathi et al. (2017) increases data reliability, whereas the comprehensive search strategy and inclusion criteria in Driscoll et al. (2018) uphold the validity of their findings.

In conclusion, selecting appropriate research methodologies aligned with the research questions enhances the overall quality of evidence. Combining diverse but complementary methodologies, such as observational studies with systematic reviews, provides a multi-faceted understanding of issues like nursing medical errors. Systematic reviews, in particular, stand out for their ability to synthesize comprehensive evidence, guide best practices, and inform policy decisions within healthcare settings, ultimately aiming to improve patient safety outcomes and reduce adverse events related to nursing care.

References

  • Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 17(1), 6-22. https://doi.org/10.1177/1474515117720227
  • Fathi, A., Hajizadeh, M., Moradi, K., Zandian, H., Dezhkameh, M., Kazemzadeh, S., & Rezaei, S. (2017). Medication errors among nurses in teaching hospitals in the west of Iran: What we need to know about prevalence, types, and barriers to reporting. Epidemiology and Health, 39, e2017004. https://doi.org/10.4178/epih.e2017004
  • Griffiths, P., Ball, J., Bloor, K., Böhning, D., Briggs, J., Dall’Ora, C., ... & Meredith, P. (2018). Nurse staffing levels, missed vital signs, and mortality in hospitals: Retrospective longitudinal observational study. Health Services and Delivery Research, 6(38), 1–134.
  • Hessels, A. J., Paliwal, M., Weaver, S. H., Siddiqui, D., & Wurmser, T. A. (2019). Impact of patient safety culture on missed nursing care and adverse patient events. Journal of Nursing Care Quality, 34(4), 317–324. https://doi.org/10.1097/NCQ.0000000000000398

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