Validity of Qualitative and Quantitative Evidence

Topic Search Strategy Paper

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Topic Search Strategy Paper

Medical errors caused by the wrong dose are one of the major causes of mortality and morbidity in healthcare and affect both the nurse and the patient. The wrong dose medication administration errors are caused by omissions, dose miscalculations, or prescription errors. According to Cavell and Mandaliya (2021), medical errors caused by the wrong dosage are experienced across all inpatient settings and depending on the magnitude of the errors, their effects range from mild drug reactions to mortality. Wrong dose errors account for approximately 22.5% of all medication administration errors that occur in clinical settings (Cavell & Mandaliya, 2021).

Significance of the Problem

Medication errors caused by the administration of the wrong drug dose are costly to hospitals, patients, nurses, families, and the entire community. These errors affect patients significantly and can cause the development of temporary conditions such as rashes and itching and slow their recovery in extreme cases. The wrong dosage can also cause the development of permanent conditions such as skin disfigurement, severe patient injuries, or mortality (Cavell & Mandaliya, 2021). Wrong-dose medication errors also affect healthcare providers such as nurses, who lack motivation in case of such an error and may suffer from mental health issues such as shame, guilt, low self-esteem, anxiety, depression, and suicidal thoughts. These errors also affect the healthcare systems as they are faced with legal suits in case of the occurrence of these errors. Families and communities are affected by a death of a patient due to wrong dose administration and often feel that this death could be avoided (Yin et al., 2021).   

The clinical question is: can the rate of medication errors caused by the wrong dose in hospitalized patients be prevented through medication reconciliation? 

PICO Question 

P - Hospitalized patients 

I - Medication reconciliation

C - No medication reconciliation

O - Reduced wrong dose medication errors

Purpose of the Paper

The purpose of this paper is to examine whether medication reconciliation intervention can prevent the rate of medication errors caused by the administration of the wrong dose among hospitalized patients. 

Level of Evidence

Type of Question 

This paper focuses on an intervention that helps prevent the rate of wrong-dose; medication errors administered to patients in a hospital setting. The research question aims at finding quantitative evidence that would support the effectiveness of the intervention and establish its applicability in actual practice to address the problem based on the quality of the evidence.  

Type of Evidence

The research question that this paper focuses on can be answered through primary studies that have tested the intervention in a scientific study. Primary studies provide high-quality evidence that is objective, comparable, reliable, credible, and devoid of bias that could establish whether medication reconciliation can prevent the rate of medication error as a result of wrong dose given to hospitalized patients. 

Search Strategy

The PICO question provided terms and phrases obtained from the intervention (I), and the outcome (O). The search terms included medication reconciliation, wrong dosage, and medication errors. The search terms ensured that the search results were relevant to the PICO question.

Type of Database 

To obtain credible evidence-based articles, I used the Chamberlain University Library database and the CINAHL database to find the most suitable articles that addressed the issue of medication errors caused by the wrong dose in detail. The initial search produced 3026 results, which was too broad and needed some refinement.

Refinement Decisions 

To filter the results, I used Boolean Operators that narrowed the results further and allowed me to add more terms and phrases during the search process. The use of quotation marks was also useful in combining the phrases to refine the search results. I also ensured I used the term scholarly articles to ensure that I only searched for the right articles. This search strategy produced 119 results. I also used the year of publication by narrowing the results to primary articles published in the last five years and this produced 23 articles that were published between 2018 and 2022. 

Most Relevant Articles

After reading summaries of the 23 scholarly articles, I identified the two most relevant articles. These articles included Uhlenhopp et al. (2020) and Digiantonio et al. (2018). These articles were most relevant because they addressed the question of how medication reconciliation is an effective intervention in addressing medication administration errors associated with wrong dosage. The articles contained most of the phrases and terms used in my search strategies such as medication reconciliation, rate of medication errors, and wrong dosage. The two articles provide credible evidence that supports the use of medication reconciliation in hospitals to address errors that occur due to the administration of wrong drug doses due to omissions, increase or decrease of dosage, or prescription errors.

References

Cavell, G. F., & Mandaliya, D. (2021). Magnitude of error: a review of wrong dose medication incidents reported to a UK hospital voluntary incident reporting system.  European Journal of Hospital Pharmacy,  28(5), 260-265. https://doi.org/10.1136/ejhpharm-2019-001987

Digiantonio, N., Lund, J., & Bastow, S. (2018). Impact of a pharmacy-led medication reconciliation program.  Pharmacy and Therapeutics,  43(2), 105.

Uhlenhopp, D. J., Aguilar, O., Dai, D., Ghosh, A., Shaw, M., & Mitra, C. (2020). Hospital-Wide medication reconciliation program: error identification, cost-effectiveness, and detecting high-risk individuals on admission.  Integrated pharmacy research & practice,  9, 195. https://doi.org/ 10.2147/IPRP.S269857

Yin, H. S., Neuspiel, D. R., Paul, I. M., Franklin, W., Tieder, J. S., Adirim, T., ... & Verhoef, P. A. (2021). Preventing home medication administration errors.  Pediatrics,  148(6). https://doi.org/10.1542/peds.2021-054666.