In a 2- to 3-page, double-spaced paper, describe three conclusions you have drawn from the findings in this study, taking into consideration the limitations of the study

Week 6 Assignment

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Week 6 Assignment

In the study by Verweij conducted in 2014, an intervention was implemented to reduce medication errors in a hospital. The intervention implemented was a tabard to be worn by nursing staff during their medication pass to limit interruptions thus lower medication administration errors. Several conclusions can be drawn about this study and its effectiveness. Their are also several practice implications for implementing the use of medication administration tabards in practice.

The Tabard Produces Positive Results

Looking purely at the results of the Verweij study, there was a definitive correlation between implementing the tabards to practice and the number of medication errors. There was a 66% reduction in the number of medication errors after implementing the tabards. (Verweij, Smeulers, Maaskant, & Vermeulen, 2014)

Some of the staff however found that the tabbards draw some unwanted looks and attention from evening visitors when no secretary is present. (Verweij et al, 2014) The tabards make them stand out as a source of information per the staff discussion. (Cite) The time at which the data is collected should be more standardized or averaged evenly between shifts as discussion with the nurses leaves the impression that there is a possible increase in interruptions in the evening. (Cite)

Acceptance and Utilization of the Tabard

In reading the staff interview and discussion about the tabard in the Verweij study, it's clear that while the tabard has a direct effect on lowering medication administration errors, not all staff were willing to even wear it. (Cite)

Reasons to not where the tabard by staff ranged from “looking ridiculous” to hygiene concerns between wearers. (Cite) Seeing the effect on the number of medication errors, it can be inferred that if changes could be made to increase staff acceptance of the tabards, the number of interruptions and medication administration errors would be even lower. (Cite) Elimination of staff excuses for not wearing the tabards seems as easy as changing the color of the tabards or standardizing the cleaning of the tabards by the hospital as discussed in the study. (Cite)

Patient Perception Considerations

Another significant concern with wearing the tabards is that patients may perceive nursing staff as unapproachable. (Cite) If patients and family perceive nursing staff as unapproachable for any questions or needs, this could have a negative impact on patient satisfaction regardless of how many medication errors were prevented.

An easy intervention to implement for this could be to make a wearable signal that is not so obvious but staff are aware of. The caveat to that is staff may still perceive nursing staff as unapproachable.

Implications in Practice

Though a tabard could be utilized in practice to attempt to reduce medication errors as evidenced by the results of the Verweij study, it may be better to use an intervention approved by staff prior to using it. One of the most evident negatives of using the tabard evidenced in the study is a negative perception of its looks and hygeine, not the positive results it produces.

Another practice implication that can be gathered from the study is that being aware that a nurse is passing medications reduces interruptions, thus the number of errors. Any way we can make others aware, tabard or not, will likely be safer for the patients.

Finally, we would need another study with any changed or improved intervention to reduce the errors in med passess to determine if staff and patient satisfaction and perception of approachability is improved along with keeping similar results in interruption and error reduction as the first study.

Though not loved or accepted by everyone, staff or patient, some form of intervention or label that displays a nurse is passing medications would likely cause a reduction in errors. The key would be to improve staff and patient acceptance while keeping it very clear the nurses are passing medications.

References

Verweij, L., Smeulers, M., Maaskant, J. M., & Vermeulen, H. (2014). Quiet Please! Drug Round Tabards: Are They Effective and Accepted? A Mixed Method Study. Journal of Nursing Scholarship, 46(5), 340-348. doi:10.1111/jnu.12092