Nursing is profession in health and social care sector and its main focus on care of families, individuals and also communities in order to recover, attain and maintain optimal life quality. Under this, it is a responsibility of health care organisations to maintain health of people and also take care of them in an effective or efficient manner (Maryudi and et. al., 2012). In this mention report discuss about the two articles Back to Basis approach to minimize ED medications errors and other is Effectiveness of a ‘Do not interrupt’ to minimize interruptions. Aims, results, methods, internal and external validity of these two journals will be discussed in given report.
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A “Back to Basics” Approach to reduce medication errors
There are many frequent errors are noticed in emergency department which cause harm to the life of patients. From the research, it is observed that 36% of medication errors are happens at administration phase. The proper medication of patients is done by nurses in most of the cases. So, it is the responsibility upon management if to appoint qualified nurses having the knowledge about medication and proper care in emergency departments. There is also need to provide adequate training which helps them to learn about new skills regarding treatment of different kind of patients for their optimum care..
The main “Aim” of this article is to reinforce basic medication procedures which helps in reduction of medication errors in emergency departments.
There are different “Methods” which are used for improving the skills and reduction of medication errors. Under this, examine that needed to provide 3 month educational programme after analysing its pre-post outcome variables (Broome, 2015). Such educational programmes is known as “ Preventing Medication and IV Administration Errors” which provides the information regarding the current errors which are happen on regular basis in emergency department and simultaneously provides the approaches which recommends practices which contributes in removal of reduction of errors. It is observed from the above article that out of 127 nurses, 75% are participated in medical programme. The three different measures are used for pre and post intervention. The first measures is about to assess the knowledge about basic medication administration procedures through use of tests. Secondly, application of the methods of survey to assess the information through behaviours which reflects the recommendation about medication practices. Thirdly, identification of the medication administration errors through use of chart reviews and voluntary error reports (Blank And et. al., 2011). The main purpose which is fulfilled through application of the approaches of educational programme is to improve the basic skills and knowledges among nurses about nursing practices which helps to provide optimum care to patients and reduction of medication errors. It is considered as international journal of Trauma nursing and disaster management and effective response in removal of errors from emergencies.
The “Results” achieved from application of above methods are:
According to the above test, it has been found that a total of 92% of results are collected from 69% of pre-test (p=.0001). As medication errors is said to be utmost frequently reported errors in the emergency situation. Globally, 36% of medication error are arises in management level. The primary purpose of this study is to reduce medication errors in the emergency department by reinforcing basic medication process. In the past research, the proportion responding that they are following specific suggestion practices “all” or “most” of total time increase in total questionnaire filled during the research process. But the modification cannot reach statistical significance of P=.9768. As per the analysis done from the above data, it has been seen that total chart which is draw from 299 pre test and 295 post test. This provide little change in total medication errors of 25% (P=.78) of total significance differences. There is certain amount of downfall seen from 1.28 to .99 errors out of total 1000 patients.
The “Discussion” it is seems to be educational interventional successful modification that is used to improve skill and knowledge of suggested medication administration practices. Henceforth, improved knowledge cannot transform to a significant alternation in practices. Maximum research is required to determine proper interventions that can modify attitude and behaviour of clinical settings (Westbrook And et. al., 2017). In order to decrease impact of medication errors, it is essential to work toward developing appropriate strategies to combat the risk of medication errors at all stages in medication use process. The relevant strategies determine strategies which is being determine from this research which consists of medication error analysis, computerised provider order entry system and automated dispensing cabinets as well as standardizing medication use as processes in medicine clinical pharmacists. This seems to be an essential aspect of limiting medication errors occurrence and to formulate development of all kind of valuable strategies.
“Trustworthiness” of study is health case is increase at faster rate. The trusting patient is placed, sometime unwillingly imposition of vulnerability and grants. An imbalance of knowledge and power characteristics related with health care relationship is unique extent, while importance of health care to attain ones of life goals to make vulnerability at higher level and selection of trust rhetorical (Henneman And et. al., 2010). This is another essential to both physician and patient. This means that the process of informed consent for the most minor of interventions at even a prescribe antibiotic that would become as time consuming according to the need for major surgery.
Effectiveness of a ‘Do not interrupt’ bundled intervention
Due to the high interruption frequency at the time of medications administrations, efficiency of strategies or policies to limit the interruptions during the medications has been examined in terms of numbers and make improvement so that errors in medication can be reduced. During medication administration, it is necessary to reduce all kinds of interrupting factors which can develop negative affect on nursing.
Its main “Aim” is to evaluate an effectiveness of ‘Do not interrupt’ bundled intervention in order to minimize non-medication interruptions to nurses at the time of medication administration.
Under this, strategies used by firm to control interruption are patient and clinician education,, reminders. The “Method” of ‘Do not interrupt' is determine errors of medications and interruptions percentages after and before execution of evidence- based effective strategies in order to limit interruptions which were measured with the help of using direct nurses observation 2PCCUs. In addition to this, nurses those are in third PCCU served as comparison group. The another method is to conduct observation of direct medication administration. At the time of person medication dose, primary outcome was non- medication affiliated interruptions. On the other hand second outcomes was multitasking rates and total interruption (Tsai, Kuang-Chao and Hsiao, 2012).
“Results” which was achieved from above application of methods are that over the 364.7 hours and 8 weeks, total 227 nursed which were observed the administrating around 4781 medications. The experience of nurses was 100 administrations/ 57 interruptions, about 87.9% were nor related to medication task observed. Experience of intervention wards a significant minimization in non- medication interruptions from 50/100 administrations to 34/100. it was reported through interruptions ward that vests were hot, time consuming and also cumbersome. There were only 48% people which support intervention which becoming the policy of hospital (Broome, 2015).
The “Conclusion” from above discussion is that nurses experienced more interruptions and some of are concerned to medication task, demonstrating scope of considerable in order to minimize unnecessary interruptions. While an interruptions are related with statistically reduction in the non- medication interruptions. There is an execution of strategies of evidence based to limit an interruptions in PCCUs reduced neglect-able interruptions and also promotes the safety of patients.
In the “Internal validity”, many of medications are very administrated to all patients every day. The all methods which are use to reduce interruptions to medication administration are valid and helpful in making the medication better (Fabienne and Helen, 2012). All methods are very reliable so that nurses can take care the health of patients in an effective or better manner. There is a systematic review of an interventions which was designed to minimize interruptions to the nurses at the time of medication administration.
“Trustworthiness” of this whole study is good an d under this there is conduct cluster, controlled and also random study in order to determine effectiveness of ‘Do not interrupt’ an intervention to minimize non- medication interruptions to the nurses at the time of medication, testing feasibility. Under this if interruption in medication administration will be reduced, then nurses can do their work in a better manner and also take care the health of patients in a better method. Methods which are used for know or remove errors in non- medication related interruptions are very trustworthy and valuable.
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It has been concluded from at the above given report that interruption is not beneficial to treat people in a better manner. If develops negative affect on medications. The aims, results, measurement validity, trustworthiness of effectiveness of a ‘Do not interrupt’ bundled intervention and also 'back to basis' studied in the mention report. In given essay, design and also test the sustainable interruptions in order to make improvement in safety of patents studies in a better manner.
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- Blank, F.S. And et. al., 2011. A “back to basics” approach to reduce ED medication errors.Journal of emergency nursing.37(2). pp.141-147.
- Broome, A., 2015. Back to basics: the great recession and the narrowing of IMF policy advice.Governance.28(2). pp.147-165.
- Henneman, E.A. And et. al., 2010. Strategies used by critical care nurses to identify, interrupt, and correct medical errors.American Journal of Critical Care.19(6). pp.500-509.
- Maryudi, A. and et. al., 2012. Back to basics: considerations in evaluating the outcomes of community forestry.Forest Policy and Economics.14(1). pp.1-5.
- Tsai, F.H., Kuang-Chao, Y. and Hsiao, H.S., 2012. Exploring the factors influencing learning effectiveness in digital game-based learning.Journal of Educational Technology & Society.15(3). p.240.
- Fabienne, D., & Helen, B. (2012). Assessing the effectiveness of environmental enrichment in bottlenose dolphins (Tursiops truncatus).Zoo biology.31(2). 137-150.