Evidence Based Interventional Nursing Assignment - University of Salford

Assignment Task

Background information

Medication administration is a key nursing intervention and a standard proficiency for all registered nurses (Nursing and Midwifery Council [NMC], 2018). However, it remains one of the most common causes of harm to patients in hospital (Roughead et al., 2013). This paper will be reviewing the best available evidence on this topic to learn more about this clinical issue and draw conclusions about how medicine administration errors can be avoided in practice. This nursing intervention will be reviewed in line with the Royal Society of Pharmacists and Royal College of Nursing (2019) Medications Administration Guidelines.

The NMC (2018) state the medication process to be complex in nature, high risk and involving multiple interactions. Adhering to the “9 Rights” during medicine administration requires much cognitive attention (Elliott & Lui, 2010) especially when multiple medications are being administered (Rohde & Domm, 2018). The RSP/RCN (2019) guidelines recognise that for medications administrations to be safe, organisations must put strategies in place to reduce risks or medication delivery. However, work interruptions or a break in the activity being performed in order to carry out a secondary task are ever present in nursing practice (Hopp et al., 2005). Hedberg and Larsson (2004) suggest nurses are interrupted 2.8 times per hour while Alvarez and Coiera (2005) state 14 times per hour. Nurses are therefore rarely able to complete any activity without being interrupted. While many interruptions may be amid benign care delivery, other intrusions such as during medicine administration, can severely compromise patient safety (Raban & Westbrook, 2014).

Search strategy

Have you completed the library activities in week 3 (library search) and 4 (database searching)?

Evidence to support practice can be drawn from four areas - research, clinical experiences of health professional, patients’ experiences and local information such as guidelines and policies (Aveyard & Sharp, 2017; Rycroft-Malone, 2004). However, primary research evidence will be used in this annotated bibliography for its objectivity (Davis, 2016). Research study was identified by searching MEDLINE (or CINAHL) health databases because.

To undertake the database search the topic was broken down into keywords that were linked together (Davis, 2016). There is an example in the appendix of the keywords used and how the search terms were linked using Boolean.

The study did not gain ethical approval as it was deemed to be an audit. However, nurses involved in the observations were requested to sign a consent form, even though consent forms are not normally used when completing audits. This demonstrates that the researchers were acknowledging ethical considerations for their participants (Grant et al., 2013; Twycross & Shorten, 2014). The observation of the nurses was disguised. Payne & Payne (2004) state that people tend to change their behaviour when being watched, the ‘Hawthorne effect’, so disguising the observation helped to prevent any altered behaviour by the nurses which could have distorted the research findings. Another positive aspect to the study was that only one observer was used (clinical pharmacist) who received 1 months’ training from a senior pharmacist before the start of the study and a standardised form was used to record potential errors. Using just one observer avoids the issue of multiple observers possibly recording scores differently, also known as inter-rater reliability, which increases the reliability of results (Parahoo, 2014; Salmon, 2015). A standard document/form to record errors allows for quick, simple and standardised categorisation.

This Medical Science has been solved by our PHD Experts at My Uni Paper.