Assessment Description
In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Develop a 1,250-1,500 words project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
Background
Clinical problem statement.
Purpose of the change proposal in relation to providing patient care in the changing health care system.
PICOT question.
Literature search strategy employed.
Evaluation of the literature.
Applicable change or nursing theory utilized.
Proposed implementation plan with outcome measures.
Discussion of how evidence-based practice was used in creating the intervention plan.
Plan for evaluating the proposed nursing intervention.
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
Appendix section, if tables, graphs, surveys, educational materials, etc. are created.
Review the feedback from your instructor on the Topic 3 assignment, PICOT Question, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
Running head: LITERATURE REVIEW-ADVERSE DRUGS EFFECTS
1
LITERATURE REVIEW-ADVERSE DRUGS EFFECTS
5
Literature Review-Adverse Drugs Effects
Student’s Name
Name of The Institution
Course Number and Name
Professor
Due Date
Literature Review-Adverse Drugs Effects
The impacts of adverse drug effects on healthcare cannot be overlooked presently. Studies have presented different evidence to show how ADEs include enhanced costs of medication, unplanned operations, increased patient mortality, and morbidity and operations. While the causes of adverse drug effects are immense (Bugnon et al., 2021). The focus has been to control the effects that result from medical malpractice by eliminating the problem from healthcare. Several scholars have investigated the problem from different perspectives. Although the scholars have approached the problem from different perspectives, all the studies are aimed at developing evidence-based solutions to the problem. The current study is not different as it compared the effectiveness of electronic medication and educating and training the nurses as means of adverse effects.
Research Questions Comparisons
The proposed study will focus on understanding how technology or electronic medication and the education and training of nurses may reduce adverse drug events among the patients, especially those suffering from chronic illnesses. The main elements of the questions are no different from the themes of the questions that have been explored in previous research. A review of the publications included in the current proposal indicates that many of the scholars focused on electronic records, medications, and how their effective interventions contribute to the reduced adverse drug effects among the patients and in a clinical setting in general. For instance, Wang et al. (2018), Kinlay et al. (2021), and Bugnon et al. (2021) in their respective studies focused on electronic medication. In the studies, the authors revealed that the effective use of electronic medication reduces adverse drug effects. Interestingly, the studies mentioned earlier are directly linked to the proposed research proposal. In the proposed study, the focus will be to investigate the effectiveness of electronic medication and the education and training of nurses to eliminate adverse drug effects. For instance, Kinlay et al. (2021) focused on the electronic medication management system. The research question explored how effective electronic medication management reduces adverse drug effects among patients with chronic illnesses. The guiding research question relevant to the currently proposed study significantly relates to the research questions that were proposed by Kinlay et al. (2021). Analysis of the research articles indicates that electronic medication takes vast account in reducing the adverse drug effects in patients. Gregory et al. (2021), is one of the few studies that incorporated a research question in their studies. The research question is also linked to the current proposal to investigate the effectiveness of education and training of nurses and electronic medication in healthcare. Many of the scholars did not employ a research question structure because of the nature of the research subject. Most comparative studies are generally quantitative since different variables are considered in the research that requires the quantification of data.
A Comparison of Sample Populations
The sample population is an important consideration for any research study, especially from a healthcare perspective. The previous studies reviewed in the current proposed study considered different population to attain their research goals. Indeed, many of the scholars did not focus on individual participants and hence did not focus on human populations but reviewed available literature from different publications to compare the elements in their questions. For instance, Li et al. (2019), Gregory et al. (2021), and Martin et al. (2018) did not focus on the human population to achieve their goals. This is no different from the proposed study which will focus on entities (healthcare organizations) that have either implemented electronic medication programs or education and training of nurses as a technique to reduce adverse drug effects. The population size approach that was taken by Bugnon et al. (2021) is very unique, especially in understanding the problem and creating the most effective solution. Bugnon et al. (2021) focus on the entire Swiss population in their study and this could have enhanced the generalization of the study findings. To enhance the generalization of the proposed study findings, the population size will be considerable hence exposing the research to a plethora of information to help deduce the findings.
A Comparison of the Limitations of the Study
Like other research studies, the current study is not devoid of research limitations. Some of the limitations are humanly created while others are caused by the system. Analysis of the previous studies indicates that research sample and selection has been the main obstacle that negatively impacts the findings. A study by Bugnon et al. (2021) noted that a small sample size for statistical measurements was a problem that may have compromised the study findings. Fuller et al. (2018) and Lau et al. (2018) in their separate studies revealed that effective data collection methods and analysis in this area were a huge obstacle for them. Indeed, such studies are complex and they require improved data collection, handling, and analysis method to yield successful findings. It is predicted that data access will be a huge limitation of the current study.
A Conclusion and Recommendations for Further Research
Analysis of the research studies related to the currently proposed study indicates that adverse drug effects pose a significant healthcare challenge. The causes of the ADEs are known and the solutions should be fast-tracked to eliminate the problem. Studies indicate that electronic medication programs are more effective in the management and control of adverse drug effects among patients as compared to other methods. Considering the dominating findings of the studies, a study should be conducted to investigate why education and training of nurses is not the preferred technique to eliminate adverse drug effects.
References
Bugnon, B., Geissbuhler, A., Bischoff, T., Bonnabry, P., & von Plessen, C. (2021). Improving primary care medication processes by using shared electronic medication plans in Switzerland: Lessons learned from a participatory action research study. JMIR Formative Research, 5(1). https://doi.org/10.2196/22319
Fuller, A. E. C., Guirguis, L. M., Sadowski, C. A., & Makowsky, M. J. (2018). Electronic Medication Administration records in long‐term Care Facilities: A scoping review. Journal of the American Geriatrics Society, 66(7), 1428–1436.
https://doi.org/10.1111/jgs.15384
.
Gregory, L. R., Lim, R., MacCullagh, L., Riley, T., Tuqiri, K., Heiler, J., & Peters, K. (2021). Intensive Care Nurses’ experiences with the new electronic medication administration record. Nursing Open, 9(3), 1895–1901.
https://doi.org/10.1002/nop2.939
.
Kinlay, M., Ho, L. M., Zheng, W. Y., Burke, R., Juraskova, I., Moles, R., & Baysari, M. (2021). Electronic Medication Management Systems: Analysis of enhancements to reduce errors and improve workflow. Applied Clinical Informatics, 12(05), 1049–1060.
https://doi.org/10.1055/s-0041-1739196
.
Lau, G., Ho, J., Lin, S., Yeoh, K., Wan, T., & Hodgkinson, M. (2018). Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian Hospital Network. Health Information Management Journal, 48(1), 12–23.
https://doi.org/10.1177/1833358317720601
.
Li, R., Zaidi, S. T., Chen, T., & Castelino, R. (2019). Effectiveness of interventions to improve adverse drug reaction reporting by healthcare professionals over the last decade: A systematic review. Pharmacoepidemiology and Drug Safety, 29(1), 1–8.
https://doi.org/10.1002/pds.4906
Martin, P., Tamblyn, R., Benedetti, A., Ahmed, S., & Tannenbaum, C. (2018). Effect of a pharmacist-led educational intervention on inappropriate medication prescriptions in older adults. JAMA, 320(18), 1889.
https://doi.org/10.1001/jama.2018.16131
Wang, H., Meng, L., Song, J., Yang, J., Li, J., & Qiu, F. (2018). Electronic medication reconciliation in hospitals: A systematic review and meta-analysis. European Journal of Hospital Pharmacy, 25(5), 245–250.
https://doi.org/10.1136/ejhpharm-2017-001441
.
Literature Evaluation Table
Student Name:
Change Topic (2-3 sentences): The aim of the evaluation is to determine the best method for reducing Adverse Drug Events (ADEs) in the older patients. Strategies being compared are educational programs and electronic medication.
Criteria
Article 1
Article 2
Article 3
Article 4
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Wang, H., Meng, L., Song, J., Yang, J., Li, J., & Qiu, F. (2018). Electronic medication reconciliation in hospitals: A systematic review and meta-analysis. European Journal of Hospital Pharmacy, 25(5), 245–250. https://doi.org/10.1136/ejhpharm-2017-001441
Kinlay, M., Ho, L. M., Zheng, W. Y., Burke, R., Juraskova, I., Moles, R., & Baysari, M. (2021). Electronic Medication Management Systems: Analysis of enhancements to reduce errors and improve workflow. Applied Clinical Informatics, 12(05), 1049–1060. https://doi.org/10.1055/s-0041-1739196
Fuller, A. E. C., Guirguis, L. M., Sadowski, C. A., & Makowsky, M. J. (2018). Electronic Medication Administration records in long‐term Care Facilities: A scoping review. Journal of the American Geriatrics Society, 66(7), 1428–1436. https://doi.org/10.1111/jgs.15384
Bugnon, B., Geissbuhler, A., Bischoff, T., Bonnabry, P., & von Plessen, C. (2021). Improving primary care medication processes by using shared electronic medication plans in Switzerland: Lessons learned from a participatory action research study. JMIR Formative Research, 5(1). https://doi.org/10.2196/22319
Article Title and Year Published
Title- Electronic medication reconciliation in hospitals: A systematic review and meta-analysis.
Year: 2018
Title: Electronic Medication Management Systems: Analysis of enhancements to reduce errors and improve workflow
Year: 2021
Title: Electronic Medication Administration records in long‐term Care Facilities: A scoping review
Year: 2018
Title: Improving primary care medication processes by using shared electronic medication plans in Switzerland: Lessons learned from a participatory action research study
Year: 2021
Research Questions (Qualitative)/Hypothesis (Quantitative)
Hypothesis: Medication reconciliation is a multi-professional process for the prevention of medication discrepancies.
No research questions/hypothesis
Null
Null
Purposes/Aim of Study
To evaluate the available electronic medication reconciliation (eMedRec) tools and their effect on unintended discrepancies that occur in hospital institutions
1. Identify system-related medication errors or workflow blocks that were the target of eMM system updates
2. Describe and classify the system enhancements made to target these risks
To map the extent, range, and nature of research on the effectiveness, level of use, and perceptions about electronic medication administration records (eMARs) in long-term care facilities (LTCFs)
Summarize lessons learned from primary care professionals involved in a pioneering pilot project in Switzerland for the system wide implementation of shared electronic medication plans.
Design (Type of Quantitative, or Type of Qualitative)
Meta-analysis
Retrospective study
Scoping review of quantitative and qualitative literature.
Formative action research study.
Setting/Sample
Meta-analysis, 13 articles included
Systematic analysis
Literature review
Longitudinal study
Methods: Intervention/Instruments
Methodological quality was assessed using the nine standard criteria of Cochrane Effective Practice and Organization of Care Review Group (EPOC)
147 individual changes, were made to the eMM system over the 4-year period
Systematically searched MEDLINE, CINAHL, Scopus, ProQuest, and the Cochrane Library.
Group interviews
Analysis
Relative risk and significance difference
Descriptive analysis (use of percentages)
Level of significance analysis
Descriptive analysis
Key Findings
Electronic Medical Reconciliation reduces the incidence of medication with unintended discrepancies and improves medication safety.
Electronic Medication Management (eMM) reduces medication errors and optimize workflows
Evidence linking electronic Medication Administration Records (eMAR) in reducing errors is weak.
Participants considered medication plan management, digitalized or not, a core element of good clinical practice
Recommendations
Hospitals adopt electronic medication to reduce ADEs
Hospital organizations can adopt eMM to enhance patient safety and operational efficiency
More research need to be conducted to determine the effectiveness of electronic medication in reducing ADEs
Digitalization is a key element of transforming hospital records
Explanation of How the Article Supports EBP/Capstone Project
It identifies the best approach that can reduce ADES between educational programs and electronic medication.
Shows that electronic Medication Management is the best bet for reducing ADEs
The article informs the need for conducting more robust research on the efficacy of electronic medication in reducing ADEs.
More research should be done to assess the efficacy of electronic records.
Criteria
Article 5
Article 6
Article 7
Article 8
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Gregory, L. R., Lim, R., MacCullagh, L., Riley, T., Tuqiri, K., Heiler, J., & Peters, K. (2021). Intensive Care Nurses’ experiences with the new electronic medication administration record. Nursing Open, 9(3), 1895–1901. https://doi.org/10.1002/nop2.939
Li, R., Zaidi, S. T., Chen, T., & Castelino, R. (2019). Effectiveness of interventions to improve adverse drug reaction reporting by healthcare professionals over the last decade: A systematic review. Pharmacoepidemiology and Drug Safety, 29(1), 1–8. https://doi.org/10.1002/pds.4906
Lau, G., Ho, J., Lin, S., Yeoh, K., Wan, T., & Hodgkinson, M. (2018). Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian Hospital Network. Health Information Management Journal, 48(1), 12–23. https://doi.org/10.1177/1833358317720601
Martin, P., Tamblyn, R., Benedetti, A., Ahmed, S., & Tannenbaum, C. (2018). Effect of a pharmacist-led educational intervention on inappropriate medication prescriptions in older adults. JAMA, 320(18), 1889. https://doi.org/10.1001/jama.2018.16131
Article Title and Year Published
Title: Intensive Care Nurses’ experiences with the new electronic medication administration record
Year: 2021
Title: Effectiveness of interventions to improve adverse drug reaction reporting by healthcare professionals over the last decade: A systematic review
Year: 2019
Title: Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian Hospital Network
Year: 2018
Research Questions (Qualitative)/Hypothesis (Quantitative)
What are intensive care nurses’ experiences with the new electronic medication administration record?
No research question and hypothesis
Null
Can a consumer-targeted, pharmacist-led educational intervention reduce prescriptions for inappropriate medication among community-dwelling older adults?
Purposes/Aim of Study
To explore the experiences of Registered Nurses who administered medications to patients using the electronic medication administration record.
To assess the impact of various strategies to improve ADR reporting published in the last decade and compare this with the strategies identified in a previous systematic review
To explore and compare patient and clinician attitudes towards an integrated e-prescribing and dispensing system
o compare the effectiveness of a consumer-targeted, pharmacist-led educational intervention vs usual care on discontinuation of inappropriate medication among community-dwelling older adults.
Design (Type of Quantitative, or Type of Qualitative)
Qualitative descriptive exploratory approach
Systematic review
A cross-sectional survey
A cluster randomized clinical trial
Setting/Sample
Five participants
10,021 articles selected, 13 articles included
Australian metropolitan teaching hospital
Quebec, Canada
Methods: Intervention/Instruments
Focus group, observation
MEDLINE and EMBASE databases
Survey
andomization occurred at the pharmacy level, with 34 pharmacies randomized to the intervention group (248 patients) and 35 to the control group (241 patients)
Analysis
Thematic analysis
Descriptive analysis
Descriptive analysis- percentages
Descriptive and inferential statistics
Key Findings
eMAR reduced time nurse spent with patients
Electronic method was found to be a better approach when reporting adverse drug reactions compared to educational method
The majority of patients and clinicians reported a positive impact of e-prescribing on safety and efficiency
A pharmacist-led educational intervention compared with usual care resulted in greater discontinuation of prescriptions for inappropriate medication after 6 months
Recommendations
More research needed on the effects of using eMAR to patients and healthcare providers.
More research needed to find the robustness of each method
Hospitals should implement e-prescribing
More research needed to establish the effectiveness of educational programs in reducing ADEs
Explanation of How the Article Supports EBP/Capstone
Electronic medication has the potential to increase patient safety
The article directly compares the effectiveness of educational programs and electronic records which are included in the PICOT question.
The study adds to the evidence that electronic medication is the best approach to reduce ADEs
The study contributes to the topic because educational program for nurses was found to be effective in dealing with ADEs.
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