Healthcare organizations



Healthcare organizations
QUESTION
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem.

Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:

Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population.
Following the PICOT format, write a PICOT question in your selected area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. Note: This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology.
Articles must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. The PICOT question will also provide a framework for your capstone project.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
Healthcare organizations

ANSWER

PICOT Question and Literature Search

Student’s Name
Institutional Affiliation
Course Name and Number
Instructor’s Name
Date

PICOT Question and Literature Search
Student Name:
Nursing Practice Problem
Healthcare organizations must ensure they offer high-quality, safe, and evidence-based care to all patients to achieve better health outcomes and improve quality of life. Providing such high-quality care requires these facilities, through efforts from various stakeholders, to develop and implement effective measures to address some of the challenges experienced within the healthcare settings, which can compromise patient safety and the quality of care they receive. Identifying the problem forms the basis for developing an intervention that will help address such an issue. This paper applies the population, intervention, comparison, outcome, and time (PICOT) framework, supported by evidence from credible literature sources, to determine the most appropriate measure to address medication errors which are a common occurrence within healthcare settings associated with adverse consequences both to patients’ health outcomes and the well-being of the caregivers.
Medication errors are a common nursing practice issue across different facilities globally, most occurring during the medication administration phase. The contributing factors can be classified into organization-based factors such as poor management and inadequate staffing, nurse-based factors such as negligence among the caregivers, and knowledge-based factors, for instance, inadequate pharmacological knowledge of the various drugs among the nurses. Of significant concern is inadequate staffing, which is a significant challenge across various health facilities globally. Meeting the recommended nurse-to-patient ratio remains a challenge for many healthcare systems. This results in a high workload and poor shifting, which results in fatigue and burnout among the caregivers. Such burnout and fatigue increase the risk of making mistakes, resulting in errors with significant adverse consequences to the patients (Menon et al., 2020). It also decreases job satisfaction, contributing to increased risks of making such medication errors.
PICOT Question
Based on the nursing practice problem identified, the PICOT question being analyzed is: in hospitalized patients (P), dose reduction in the nurse-to-patient ratio (I) compared to no measure taken to address inadequate staffing (C) helps in reducing medication errors and improving patient safety and health outcomes (O) within six months (T)?
Literature Evaluation Table
Criteria Article 1 Article 2 Article 3
APA-formatted article citation with permalink Melnyk, B. M., Orsolini, L., Tan, A., Arslanian-Engoren, C., Melkus, G. D. E., Dunbar-Jacob, J., & Lewis, L. M. (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), 126-131. https://www.ingentaconnect.com/content/wk/jom/2018/00000060/00000002/art00012
Bolandianbafghi, S., Salimi, T., Rassouli, M., Faraji, R., & Sarebanhassanabadi, M. (2017). Correlation between medication errors with job satisfaction and fatigue of nurses. Electronic physician, 9(8), 5142. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614304/
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. 1571-1580). Elsevier. https://www.sciencedirect.com/science/article/pii/S0025619618303720

How does the article relate to the PICOT question? The article determines the link between nurses’ physical and mental health and the incidences of medication errors. It aims at determining the relationship between job satisfaction and fatigue among nurses to medication errors. It determines the link between physician burnout and their well-being on the incidences of reported medical errors.
Is the article qualitative, quantitative, or mixed methods?
Justify your selection. Mixed method; quantitative data was taken regarding the number of nurses with mental and physical health issues and errors compared with those with better health status. Qualitative, as it focuses on making comparisons between the factors and incidences of medication errors. Mixed; it involved determining the number of physicians reporting burnout and affected well-being and linked it with the incidences of medication errors.
Purpose statement To determine nurses’ physical and mental health status and establish the relationship with incidences of medication errors. To determine the relationship between job satisfaction and fatigue among nurses to incidences of medication errors. To evaluate burnout and well-being among the physicians and their relationship to significant medical errors.
Research question(s) How does nurses’ status of health impact the incidence of medical errors? How do job satisfaction and fatigue among nurses relate to the incidences of medication errors? Do physician burnout and well-being contribute to medical errors?
Outcome(s) More than half of nurses reported below the recommended mental and physical health state. More than half of the affected nurses also reported having experienced a medical error in the past few years. There was no significant relationship between job satisfaction and fatigue among nurses to incidences of medication errors. Physicians with burnout and a low state of well-being reported increased incidences of medical errors.
Setting
(Where did the study take place?) Across the U.S. Shahid Sadoughi hospital in Yazd-Iran The U.S.
Sample 1790 nurses 170 nurses working in Shahid Sadooghi hospital 6696 physicians
Method Cross-sectional descriptive survey A descriptive study involving the use of questionnaires Population-based survey
Key findings of the study and implications for nursing practice There is a strong link between the wellness status of the nurses and incidences of medication errors. Age was the only determinant that was correlated with the incidences of medication errors. Physician burnout and fatigue were independently linked to incidences of medication errors among physicians.
Recommendations of the researcher Reducing burnout and promoting the wellness of caregivers are vital in preventing medical errors. Further studies should be conducted in this area since job satisfaction and fatigue cannot be disregarded for their effects on medication errors. Measures to address medication errors should ensure physicians’ safety and well-being.

Criteria Article 4 Article 5 Article 6
APA-formatted article citation with permalink SHoHani, M., & Tavan, H. (2018). Factors affecting medication errors from the perspective of nursing staff. J Clin Diagn Res, 12(3). https://www.researchgate.net/profile/Masoumeh-Shohani/publication/324405979_Factors_Affecting_Medication_Errors_from_the_Perspective_of_Nursing_Staff/links/5af587dea6fdcc0c030bb2e3/Factors-Affecting-Medication-Errors-from-the-Perspective-of-Nursing-Staff.pdf
Menon, N. K., Shanafelt, T. D., Sinsky, C. A., Linzer, M., Carlasare, L., Brady, K. J., & Trockel, M. T. (2020). Association of physician burnout with suicidal ideation and medical errors. JAMA network open, 3(12), e2028780-e2028780. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2773831
Trockel, M. T., Menon, N. K., Rowe, S. G., Stewart, M. T., Smith, R., Lu, M., … & Shanafelt, T. D. (2020). Assessment of physician sleep and wellness, burnout, and clinically significant medical errors. JAMA network open, 3(12), e2028111-e2028111. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2773777

How does the article relate to the PICOT question? It aims at determining factors that contribute to medication errors, where staff burnout due to workload is a significant factor. The article determines the association between burnout among physicians to incidences of medical errors. It helps determine how sleep impairment due to long working hours can contribute to clinical errors.
Is the article qualitative, quantitative, or mixed methods?
Justify your selection. Qualitative; it involved questionnaires where participants were to report the contributing factors to medication errors. Quantitative; as the incidences of medical errors were compared between physicians having burnout with those not experiencing burnout. Quantitative; since it aims at determining the number of caregivers with sleep impairments and incidences of medical errors among them.
Purpose statement To explore the various factors contributing to medication errors from nurses’ perspectives. To determine the association between physician burnout and depression with self-reported incidences of medical errors. To determine sleep-related impairments among clinicians and how the impairments result in self-reported medical errors.
Research question(s) What are the various factors that increase the likelihood of committing medication errors from your (nurse) perspective? What is the incidence of medical errors among physicians having burnout compared to those not experiencing burnout? How are sleep impairments among clinicians related to incidences of self-reported errors?
Outcome(s) Inadequate staffing, burnout, exhaustion among nurses, and high workload were among the top 3 reported factors contributing to medication errors. Burnout is associated with increased incidences of self-reported medical errors. There is a dose-response association between sleep impairments among clinicians to incidences of self-reported medical errors.
Setting
(Where did the study take place?) Teaching hospitals of Ilam. The U.S. Eleven institutions in the U.S.
Sample 120 nurses randomly selected 1355 physicians Nineteen thousand three hundred eighty-four attending physicians and 7257 house staff physicians.
Method Two-part standard questionnaire Online survey Wellness survey
Key findings of the study and implications for nursing practice Work overload, nurse exhaustion, and burnout due to inadequate staffing and poor shifting are important causes of medication errors. Physician burnout is a major contributing factor to increased incidences of self-reported medical errors. Sleep impairments due to long working hours affect the well-being of caregivers and increase their incidences of self-reported medical errors.
Recommendations of the researcher Adequate staffing and ensuring adequate personnel per shift are critical in preventing medication errors. Addressing medical errors should prevent burnout among physicians through adequate staffing to reduce workload. Further investigations should be conducted to determine how to reduce and prevent sleep impairments among caregivers to prevent harm to patients.

Conclusion
The findings from the literature search show a strong link between the nurse-to-patient ratio to the incidences of medication errors. High nurse-to-patient ratios result in a high workload, which causes fatigue and burnout among the caregivers. Such fatigue increases incidences of medication errors; thus, interventions should be aimed at reducing such fatigue, for instance, through adequate staffing and proper shifting.

References
Bolandianbafghi, S., Salimi, T., Rassouli, M., Faraji, R., & Sarebanhassanabadi, M. (2017). Correlation between medication errors with job satisfaction and fatigue of nurses. Electronic physician, 9(8), 5142. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614304/
Melnyk, B. M., Orsolini, L., Tan, A., Arslanian-Engoren, C., Melkus, G. D. E., Dunbar-Jacob, J., & Lewis, L. M. (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), 126-131. https://www.ingentaconnect.com/content/wk/jom/2018/00000060/00000002/art00012
Menon, N. K., Shanafelt, T. D., Sinsky, C. A., Linzer, M., Carlasare, L., Brady, K. J., & Trockel, M. T. (2020). Association of physician burnout with suicidal ideation and medical errors. JAMA network open, 3(12), e2028780-e2028780. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2773831
SHoHani, M., & Tavan, H. (2018). Factors affecting medication errors from the perspective of nursing staff. J Clin Diagn Res, 12(3). https://www.researchgate.net/profile/Masoumeh-Shohani/publication/324405979_Factors_Affecting_Medication_Errors_from_the_Perspective_of_Nursing_Staff/links/5af587dea6fdcc0c030bb2e3/Factors-Affecting-Medication-Errors-from-the-Perspective-of-Nursing-Staff.pdf
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. 1571-1580). Elsevier. https://www.sciencedirect.com/science/article/pii/S0025619618303720
Trockel, M. T., Menon, N. K., Rowe, S. G., Stewart, M. T., Smith, R., Lu, M., … & Shanafelt, T. D. (2020). Assessment of physician sleep and wellness, burnout, and clinically significant medical errors. JAMA network open, 3(12), e2028111-e2028111. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2773777

Healthcare organizations


Scroll to Top