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Advanced Levels of Clinical Inquiry and Systematic Reviews

Student’s Name

Instructor’s Name

Institution Affiliation

Date

Medication Errors

Medication errors are the most common life-threatening harms in clinical settings.

Usually, they are broadly defined as errors that occur in;

prescribing

dispensing

and administration of drugs.

They can cause severe injury and possible death to patients.

According to Tariq et al. (2021), 7 000 to 9,000 hospitalized patients die each year due to medication errors in the United States.

They can also cause severe financial, psychological, and emotional stress to healthcare providers and institutions.

Analyzing this clinical issue further may help establish the best practice for avoiding medication mistakes.

Source; Research Gate

Regardless of whether medication errors result in adverse consequences or not, they are the single most preventable causes of patient harm (Gorgich et al., 2016). Some of them occur due to poor prescribing. Insufficient medication knowledge is also often linked to factors that facilitate increased cases of medication errors among hospitalized patients. Unfortunately, nurses are the most blamed individuals for this problem as they are perceived to lack adequate knowledge regarding medication and prescription.

PICO(T) Question

The PICO question was developed based on a specific clinical domain; intervention.

Specifically evidence-based technological interventions for reducing medication errors.

The following questions guided the formulation of the PICO(T) question

Who is the patient or the target population in question?

What is the intervention (treatment) in consideration?

What are other evidence-based interventions for medication errors in consideration?

What is the overall objective/outcome/ consequences of the research?

Is there a time period that should be accounted?

Source; Research Guide

The Research Databases

The four selected research databases have proven effective in the past.

They include;

PubMed

Walden Google Scholar

CINAHL (Cumulative Index to Nursing and Allied Health Literature)

Medline

The Selected Peer-Reviewed Articles

The chosen articles were selected based on their research methodology.

They were also picked because of their study focus, ideas, and suggestions.

The articles are;

Izadpanah, F., Nikfar, S., Imcheh, F. B., Amini, M., & Zargaran, M. (2018). Assessment of frequency and causes of medication errors in pediatrics and emergency wards of teaching hospitals affiliated to Tehran University of Medical Sciences (24 Hospitals). Journal of Medicine and Life, 11(4), 299.

Whitehair, L., Provost, S., & Hurley, J. (2014). Identification of prescribing errors by pre-registration student nurses: A cross-sectional observational study utilising a prescription medication quiz. Nurse education today, 34(2), 225-232.

Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Global journal of health science, 8(8), 220.

Simonsen, B. O., Daehlin, G. K., Johansson, I., & Farup, P. G. (2014). Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: comparative study. BMC health services research, 14(1), 1-11.

Level of Evidence of The Selected Peer-Reviewed Articles

Experts often use an evidence pyramid to assess the evidential strength of research.

Studies with the highest internal validity and a high degree of quantitative analysis reside at the top of the pyramid.

Simonsen et al. (2014)

The study was designed as a comparison of two cross-sectional studies.

Since the evidence used was from well-designed case-control studies,

It falls under level III in the evidence pyramid (Murad et al., 2016).

Whitehair et al. (2014)

This study used a cross-sectional observational design.

This type of methodology falls under level II in the pyramid.

Source; Dental Care. com

An evidence pyramid primarily depicts the evidential strength of a research design in research articles. According to Burns et al. (2011), the highest level of evidence are depicted by articles that employ systemic reviews, critically-appraised topic and meta-analysis. Therefore, these four research articles are worth acknowledging and evaluating as they employed one of those elements.

Level of Evidence of The Selected Peer-Reviewed Articles

Gorgich et al. (2016)

This research material ensured the use of quality evidence.

For instance, the data was collected using a questionnaire after confirming its reliability and validity.

Also, the face and content validity was determined by ten educators, nurse educators, and Statistics advisors.

By confirming reliability and validity, they ensured that the level of evidence employed and presented had quality.

Izadpanah et al. (2018)

This article integrated a cross-sectional descriptive study conducted on 423 nurses.

This methodology also resides in level III.

It also ensured high-quality evidence by for instance;

Allowing three faculty members to verify the questionnaire's content validity.

using an intraclass correlation index to verify the reliability of the questionnaire

And internal consistency was verified by Cronbach's alpha test (Izadpanah et al., 2018).

Strengths of Systematic Reviews

Meta-analysis and systematic review studies are often recommended in research

They are perceived to provide the highest levels of evidence for verifying the effectiveness of interventions.

In clinical research, they provide a more precise estimate of the effect size.

They also increase the generalizability of the results of individual studies.

Systematic reviews are more transparent and have more rigor than other designs (Miranda et al., 2018).

Source; CanadiEm

According to Miranda et al. (2018), systematic reviews contribute to the development of quality evidence in clinical research. Due to this fact, they are given the great importance of systematic in the presentation of methodological rigor. On the other hand, Meta-analysis research methodology aims to generate a quantitative estimate of a research topic, for example, the effectiveness of a medication error intervention. It can yield conclusive results when conclusive studies are inconclusive.

Reference

Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011). The levels of evidence and their role in evidence-based medicine. Plastic and reconstructive surgery, 128(1), 305.

Murad, M. H., Asi, N., Alsawas, M., & Alahdab, F. (2016). New evidence pyramid. BMJ Evidence-Based Medicine, 21(4), 125-127.

Miranda, V. S. G. D., Marcolino, M. A. Z., Rech, R. S., Barbosa, L. D. R., & Fischer, G. B. (2019, March). Evidence-based speech therapy: the role of systematic revisions. In CoDAS (Vol. 31). Sociedade Brasileira de Fonoaudiologia.

Tariq RA, Vashisht R, Sinha A, et al. Medication Dispensing Errors And Prevention. [Updated 2021 May 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519065.