Nursing Capstone Project Paper on Review of Literature

of Literature


            In the modern health care system, the nurse plays a fundamental
purpose of ensuring surgery of patients is safe. Medication is one of the most
significant factors that ensure there is a positive outcome in every condition
diagnosed. The literatures reviewed indicate that medication errors can occur
in any health care setting, especially surgery. Shocking statistics are
presented clearly to demonstrate the contemporary nature of the problem. Moreover,
it is arguable that harm has been done to patients undergoing knee surgery and
that much of the harm is preventable. Medication error as a problem is
comprehensive and not exclusive to particular sectors in health care. In addition,
the literatures address the standards that are applicable in reducing such
startling statistics.  Nonetheless, the
role that nurse education play, especially for the nursing practice teams
handling surgery patients should be valued. Educational measures and clinical
strategies used together pose a potential yield in the general health setting
with positive results possible in fighting medication error in patient care.

            The synergy of education on the recognition, resolution,
and prevention of medication error during surgery offers a potential
opportunity in comprehensively managing the problem from a holistic
perspective. There are relative education programs implemented to ensure nurse
practitioners charged with the responsibility of administering medication do
not make mistakes. Education has an imperative function in the prevention of
medication errors during surgery sessions. As the literatures argue out, it is
of significance for the nurse practitioners to acquire and maintain competency
in their practice since medication management is crucial in the elimination of
mistakes when administering medication. From the perspective of the
contemporary nursing and the progressive nature of the professional
development, education plays a strategic role in ensuring there are minimal
cases of medication errors experienced, and the level of competency is enhanced.
Such tailored education in cases of nursing medication management has
fundamental foundations established at the earliest time possible in a nurse practitioners
career. It continues beyond the pre-registration level.

Article analysis

J., & Leufer, T. (2013). The strategic role of education in the prevention
of medication errors in nursing: Part 2. Nurse Education in Practice, 13
(3), 217-220.

of Article

            The report will assist in analyzing the strategic role
that education play in preventing errors during medication in a healthcare
setting that handle surgery cases. Pragmatic proposals are presented in
relation to the solutions that the study will focus on reducing medication
errors in nursing. Moreover, the article evaluates how education assists in
preparing nurse practitioners for their specific roles in ensuring a reduction
of errors, enhanced patient care, and outcome in the general health care


            The report sheds light on the fundamental role that
education plays in the eradication of the medication error problem, especially
with the nurse practitioners handling knee surgery patients. Education is considered
a potential factor in both clinical and academic settings in the preparation of
nurse practitioners for specific roles in medication administration and marking
reduction in errors to enhance surgery patient outcomes in such healthcare area
of practice. From the article, the major area identified to cause medication
errors is the inability of nurse practitioners accurately to calculate drug
dosages that include ratios, multiplying factions, and information
interpretation. The statistics presented in the article indicates that up to 10
percent errors in medication occur as a result of miscalculation. The report
concludes that nursing competency in medication calculation forms part of an integrated
process to ensure safe medication to surgery patients. Causes of deficiency in
such skills pose risk to knee surgery patients as there is the probability of
medication errors that may result to harm.

to Nursing and Patient Care

            From the literature, the article presents, medication
error in nursing practice is a general interest, and the implementation of
strategies meant to assist in curbing it is a concern for the overall health
care system globally.  The report
suggests the significant ways through which the problem can be solved. The
author argues that addressing the problem should involve every professional
group in the health care sector that relies on nurse practitioners to handle
medication administration to surgery patients. This would necessitate focusing
on the problem itself, scrutinizing every practice in the area, and identifying
the potential factors that contribute to the problem with an effort to address
possible solutions. This is vital to nursing practice and patient care,
following the practical aspects addressed with an initiative of reducing nurse
practitioners contribution to the multi-disciplinary concern. It is of
significance for the nurses to be open to the initiatives proposed to ensure a
successful nursing practice.

Y., & Mark, B. (2009). Antecedents of severe and non-severe medication
errors. Journal of Nursing Scholarship, 41 (1), 70-78.

of Article

            This article investigates the concept of medication error
in nursing practice through evaluating its background. The article uses a
longitudinal study in providing statistical data to evaluate the significance
of the medication error problem in the United States health care system. The
article argues that severe and non-sever medication errors indicate different
antecedents. It concludes that prevention studies as part of nursing should be
implemented to assist in improving nursing practice.


            The research design used in the article is a longitudinal
study that included 6-month data collection from 146 hospitals and 279 nursing
units selected randomly from health institutions in the US. Moreover, the study
methods associated work environmental aspects, person aspects including
experience and training, team factors, such as communication, patient factors,
and medication support services like previous hospitalization records and
health status. In the study, the research data used was obtained from a
multisite organizational study that investigated the associations among the
internal and external environments of a healthcare setting, working conditions,
staffing adequacy, and patient outcome. 146 hospitals were used for the study
for six months randomly with each having two medical, surgical specialties. Three
questionnaires were used to collect data on nurse practitioners experience, education,
expertise in medication, and work dynamics. The study involved ten randomly
selected patients from every nursing unit to provide data during the end of the
data collection period.

            The study involved the use of both dependent and
independent variables. The dependent variables conceptually defined medication
error in nursing practice as a mistake incurred during medication
administration rather than medication prescription. Numbers of errors in
medication were measured over the six months of data collection. The data were
primarily retrieved from major incident reports from the health care
institutions used. The errors that resulted from cases of technical tests or
enhanced nursing observation were registered under the severe medication errors
notion with the rest registered as non-severe error. With the independent
variables, the nurse practitioners work dynamism measurement was done through a
Likert-form questionnaire. This involved questions on the characterization of
nursing units with regular interruptions. The scale used involved an anchorage
on six response options that ranges from a strongly agree strongly to disagree.
The higher scores in the study indicated the significant work dynamics.


            In the study, the expertise of the nurse practitioners
had a negative relation with the medication errors while medication
administration-related support had a positive relation with similar medication
errors. Moreover, the education level of the nurse practitioners indicated a
potential nonlinear association with severe type medication errors. In
addition, the article indicates that the increment in the number of competent
nurses led to a corresponding decrease in medication errors.

to Nursing and Patient Care

            The study proves that medication errors classified as
severe and non-severe both play a significant role that has different
antecedents. Nonetheless, this has both nursing and patient care relevance as
medication error prevention and management concepts are analyzed to match the particular
types of error aforementioned for overall health care system best results.

R. L., Bates, B. A., Benitz, W. E., & Burchfield, D. J. (2003). Prevention
of medication errors in the pediatric inpatient setting. Pediatrics, 112 (2),

            Based on a pediatric inpatient environment, the article
reviews the significant steps that should be considered to assist in avoiding
any medication error. The
report does not provide statistical data to elaborate on the significance of
the problem, but highlights the basic rate of error occurrence in the
general healthcare sector. According to Gorman, in ensuring cases of medication
error are minimal, healthcare environments should have effective programs that
can handle reported error occasions based on the competency of nurse

A., & Doan-Johnson, S. (2002). Executive summary: Toward taxonomy of
nursing practice errors. Nursing Management, 33 (10), 45-48.

            The article argues that nurses have been playing a
significant role in the reduction of errors in medication. The article provides statistical
data for categorizing errors, and demonstrates the significance of handling the
problem efficiently. The report supports the proposed changes to ensure the
aspect of medication error is minimized.

C. H., Smith, C. R., Newkirk, L. E., & Hicks, R. W. (2007). Pediatric
medication errors in the post anesthesia care unit: Analysis of MEDMARX data.
Association of Operating Room Nurses. AORN Journal, 85
(4), 731-740

            The article addresses the problem as a common factor in
nursing practice. It provides
data to exhibit the significance of reducing medication errors based on records
from databases. The author uses descriptive statistics in comparing data sets
to support the proposed solutions to the issue after highlighting the different
causes known to practitioners.

D. P., Bojita, M. T., Revnic, C., & Popa, A. (2014). Patterns of medication
use among Romanian nursing homes residents. Pharmacology & Pharmacy, 5
(6), 560-569.

            The article focuses on the medication patterns as applied
in Romanian nursing homes. Medical statistical data from clinical pharmacists
are reviewed to
demonstrate the significance of the problem. The article supports some of the
aforementioned proposed changes meant to ensure medication errors are minimal
in nursing.

S. C., Hicks, R. W., & Becker, S. C. (2003). Medication errors in the OR–a
secondary analysis of medmarx. Association of Operating Room Nurses.AORN
Journal, 77
(1), 122-129, 132-134.

            In this article, the aspect of errors in medication in
the operating room is discussed with a focus on nurse practitioners. It provides statistical information
from a collective secondary study report from USP and AORN. The findings give
an insight into the common medication errors in nursing and causes meant to
assist in developing prevention strategies as proposed in the study.

H. (2004). Pediatric medical errors part 3: Safety strategies medication use
system to analyze errors. Pediatric Nursing, 30 (4), 334-335.

            In the article, Cohen argues that the most fundamental
strategy considered in the health care system as a prevention measure for
medication errors, especially when handling surgery patients is acknowledging
that the process used in nursing administration, pharmacy dispensing, and
prescriber ordering apply in the entire medication-use structure. The article
uses statistical information in tables to show system failures in the
medication administration process that result in cases of drug overdose and
death. It concludes by providing vital safety strategies that should be
considered as aforementioned in the study proposal.

N. L., Shane, R., Schneider, P., & Flynn, E. (2003). The impact of
dedicated medication nurses on the medication administration error rate.
Archives of Internal Medicine, 163
(19), 2359-2367.

            This article addresses the possible impacts of dedicated
medication nurse practitioners on the administration of medication and rate of
errors. The study used random study statistical information from two hospitals
with surgery setting to examine the significance of the medication problem, and
how it can be decreased through dedicated nurses focusing on drug
administration process. Moreover, the report proposes similar solutions to the
research proposal by suggesting that the use of dedicated nurse practitioners
in administering medication does not significantly contribute to error
reduction compared to competent and educated nurses.

M., Tossavainen, K., Turunen, H., & Smith, A. (2005). Potential errors and
their prevention in operating room teamwork as experienced by Finnish, British
and American nurses. International Journal of Nursing Practice, 11 (1),

            The study evaluates some of the most potential medication
errors that occur in surgery rooms and the possible solutions as experienced by
nurses in Finland, Britain, and America. The article uses statistical
information collected using interviews and analyzed through qualitative
analysis. The article concludes by proposing that balance of medication
error-making should be first recognized as significant in order to learn from
them. Moreover, this includes reporting of incidents and adopting a strategic
reporting system to handle such cases.

K., & Wallace, S. (2003). Teaching baccalaureate nursing students to
prevent medication errors using a problem-based learning approach. Journal
of Nursing Education, 42
(10), 459-464.

            The article addresses the significance of using the
baccalaureate nursing curriculum in teaching students how to prevent medication
errors through a problem-based learning approach. This is in order to
facilitate a transforming medication administration and error knowledge into
practical concepts in a clinical setting. The report does not provide data to evaluate the
significance of the problem but proposes that the aforementioned reinforcement
will enable the nursing students to employ the critical skills necessary in
developing confidence for safe, professional practice potential errors.

H., Robinson, E. S., & Mandrack, M. (2003). Getting to the root of
medication errors: Survey results. Nursing, 33(9), 36-45.

            In this article, Cohen analyzes poll results from an
investigation of nurse practitioners experiences and attitudes in relation to
error in medication administration and reporting of such cases. The article does not provide any
statistical data to evaluate the significance of the problem, but supports the
proposed changes through discussing the potential implications. It concludes by
providing more information on how making medication use a safer process in the
health care system.

B., & Latham, C. (2014). The changing landscape of the Nephrology nursing
care environment in the United States over the last 45 years. Nephrology
Nursing Journal, 41
(2), 183-90.

            The article focuses on the aspects that have contributed
to changing of the US Nephrology nursing care setting. The study involves
statistical information that focuses on the aspect of medication administering
and nurse practitioner’s contribution to the growth of the healthcare system.
The study notes the potential changes in nursing that have assisted in
improving health care delivery noting the use of technology as a vital factor.

M. E., Darbyshire, P. L., Plake, K. S., Oswald, C., & Walters, B. M.
(2009). Laboratory session to improve first-year pharmacy students’ knowledge
and confidence concerning the prevention of medication errors. American
Journal of Pharmaceutical Education, 73
(6), 1-99.

            This study evaluates the laboratory sessions that could
be of significance in improving the awareness and self-confidence of first-year
students in relation to the concept of preventing medication errors. It argues
that the provision of active education experiences could assist recognize,
resolve, and prevent medication errors. The study does not involve statistical
information on the problem, but proposes that student awareness of their role
in preventing and reducing medication errors through improving their confidence
and ability on the subject matter is vital.

S. (2002). Wake-up call–standardization is crucial to eliminating medication
errors. Association of Operating Room Nurses. AORN Journal, 75 (5),

            This study argues that standardization is a critical
factor in the elimination of medication errors. Beyea proposes that the
development of consensus and application of safe practice concepts of
medication administering contributes to potential change nursing practice.
However, despite other believing, they can be exempted from such measures.
Nurse practitioners and clinicians should work together in ensuring the
medication process is standardized and error-free.

Incorporating Theory

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