Nursing Essay Paper on Identifying a Problem, Developing a Question, and Selecting Sources of Literature

a Problem, Developing a Question, and Selecting Sources of Literature


  1. Developing
    a Question

components of PICOT

P- In adult patients
undergoing knee replacement surgery

I- What is the impact
of education

C- Compared to other
external factors

O – On the recognition,
resolution, and prevention of medication errors

T- During surgery


            In adult patients undergoing knee replacement surgery,
what is the impact of education compared to other external factors in nursing on
the recognition, resolution, and prevention of medication error during surgery?

  • Identifying
    the Problem

            In the contemporary healthcare setting, pharmacological
concepts are created to ensure the positive therapeutic outcome is achievable,
especially for surgery patients while preventing cases of inadequate drug
reactions. There are patients who die yearly in medical institutions because of
preventable medication mistakes. Medication is a fundamental aspect in a
nursing role since it associates with risks. In nursing, caution must be
ensured to shun cases of medication mistakes when handling patients undergoing
knee replacement surgery. This is because nurse practitioners are responsible
in administering medications. A medication error is a common problem in
professional practice. Moreover, such medication errors not only result in
death cases but also significant financial burden. Medication errors in nursing
as a shared problem across various surgical disciplines can be solved through

            Medication errors have also weakened support and confidence
in nursing and the entire healthcare setting. The study will focus on the
strategic role that education plays in preventing errors in contemporary
nursing, especially when administering medication during knee replacement surgery.
It will include the aspects of safe medication delivery to surgery patients,
such as the correct dose, right patient, correct route, right drug, and time. The
study will analyze the complexity of the nursing role in knee replacement
surgery and system factors that may cause medication errors. In present-day
nursing, there are fundamental nodes in medication administration where such errors
occur. In surgery, they include documenting, administering, and monitoring. Moreover,
medication errors happen due to poor handwriting in cases of prescription, especially
when handling written or printed orders. Nurse practitioners should be aware of
such cases since it may involve dangerous abbreviations in most cases.

            Education has demonstrated to be one of the most
significant aspects in preventing errors during medication. The study will
prove how education is an integral aspect in detecting and solving medication
errors. Nurse practitioners involved in medication administration in the
contemporary health system are well educated and competent on current
medications. Such levels of competency enable nurses to detect cases of error
more quickly and intercept, regardless of the source before they reach the intended
surgery patients. The application of information technology in handling
medication, including handheld computers has facilitated the elimination of overdependence
on handwritten order medication. Nurse practitioners have also been able to
access standardized medication protocols and policies to assist in avoiding
cases of confusion.

            Contemporary nursing practice has ensured nurse
practitioners who handle knee replacement surgery patients are competent enough
to avoid the incidence of medication errors. This improves the general outlook
of nursing system. In addition, nurses also promote progressive monitoring of
medication error, potential cases through educating fellow nurses on the
significance of medication awareness. Moreover, the implementation of
medication errors in nursing is a significant aspect in the general healthcare
system following the consistent cases of errors that may occur in hospital
settings, especially with surgery patients. Healthcare practitioners, handling knee
replacement surgery patients should therefore put safety first ahead of
timelines, especially nurses. Nurses have to exercise caution when handling
medication, and when errors occur, they should report it since there are
chances that it could also happen to other patients in related circumstances.

  • Selecting
  1. Chang,
    Yun-Kyung, R.N., PhD., & Mark, Barbara A, RN, PhD., F.A.A.N. (2009).
    Antecedents of Severe and Nonsevere Medication Errors. Journal of
    Nursing Scholarship, 41
    (1), 70-8.

            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.

  1. Gorman,
    R. L., Bates, B. A., Benitz, W. E., Burchfield, D. J., & al, e.
    (2003). Prevention of medication errors in the pediatric inpatient
    setting. Pediatrics, 112(2), 431-6.

            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 is minimal, healthcare environments should have effective programs that
can handle reported error occasions based on the competency of nurse

  1. Woods,
    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 article supports the proposed changes to ensure the
aspect of medication error is minimized.

  1. Cleary-Holdforth,
    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.

            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

  1. Payne,
    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),
    731-40; quiz 741-4. doi: (07) 60147-1

            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.

  1. Primejdie,
    D. P., Bojita, M. T., Revnic, C., & Popa, A. (2014). Patterns of
    medication use among Romanian nursing home 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.

  1. Beyea,
    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), 122-9, 132-4.

            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.

  1. Cohen,
    H. (2004). Pediatric medical errors part 3: Safety strategies medication
    use system to analyze errors. Pediatric Nursing, 30 (4), 334-5.

            In the article, Cohen argues that the most fundamental
strategy considered in the healthcare 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.

  1. Greengold,
    N. L., Shane, R., Schneider, P., Flynn, E., & al, e. (2003). The
    impact of dedicated medication nurses on the medication administration
    error rate. Archives of Internal Medicine, 163 (19), 2359-67.

            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.

  1. Silén-Lipponen,
    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,
    (1), 21-32.

            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.

  1. Cohen,
    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.

  1. Bednar,
    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, 199; quiz 191.

            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.

  1. Kiersma,
    M. E., PharmD., Darbyshire, P. L., PharmD., Plake, K. S., PhD., Oswald,
    C., PharmD., & Walters, B. M., PharmD. (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.

  1. Beyea,
    S. (2002). Wake-up call–standardization is crucial to eliminating
    medication errors. Association of Operating Room Nurses. AORN Journal,
    (5), 1010-3.

            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 medication
process is standardized and error-free.

  1. Papastrat,
    Karen, M.S.N., R.N., & Wallace, Sharon, M.S.N., R.N. (2003). Teaching
    baccalaureate nursing students to prevent medication errors using a
    problem-based learning approach. Journal of Nursing Education, 42 (10),

            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.

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