Clarifying Connections: Practice Problem, Evidence, and the Need for Practice Change

Results of the Literature Review and the Connection to the Practice Problem
My literature review sought to analyze relevant and current literature on medical and
surgical errors, especially the potential causes, impacts, and most importantly, how to reduce
them in clinical settings. The literature review suggests that medical errors are widespread in
healthcare and result in adverse patient outcomes, such as increased mortalities, length of
hospital stay, and cost of care (Ahmed et al., 2019). Medication errors jeopardize the safety and
quality of care in clinical settings. Evidence in the literature review further indicates that
unavailability of adequate training, insufficient work experience, lack of guidelines for
medication administration or non-adherence, and overburdening employees by allowing them to
work at night were are the primary causes or predictors of medical/surgical errors (Wondmieneh
et al., 2020). Working at night is one of the stressors associated with burnout and fatigue. Other
causes include poor collaboration, miscommunication, medical negligence, and lack of support
systems (Ahmed et al., 2019).
The literature review also suggested several potential solutions to medical and surgical
errors, including improving healthcare provider resilience by training on coping skills to
overcome stressors like burnout (Parks-Savage et al., 2018) and embracing culture changes like
systems improvements and organization-wide measures, such as policies that enhance safety
(Tsiga, Panagopoulou, & Montgomery, 2017). Other interventions include encouraging
providers to act professionally and ensuring control systems, such as accreditation, define roles
precisely (Salar, Kiani, & Rezaee, 2020), and implementing behavioral changes to enhance
handwritten prescriptions (Yousef & Yousef, 2017).

WEEK 10 DISCUSSION 3
Synthesis of Evidence and the Need for a Practice Change Initiative
According to Westlake (2012), literature synthesis can help nurses answer clinical
questions for practice implementation. The evidence I collected suggests that medical and
surgical errors are widespread and impact several patient outcomes, including the safety and
quality of care. These outcomes are linked to higher mortalities, increased hospital stay length,
and medical costs for patients. Therefore, there is a need to implement change initiatives and
interventions that tackle medical errors in clinical settings. This would guarantee patient safety,
better care quality, and reduced deaths from preventable nurse actions, such as inaccurate
prescribing (Ahmed et al., 2019).

WEEK 10 DISCUSSION 4

References

Ahmed, Z., et al. (2019). Medical errors: Healthcare professionals’ perspective at a tertiary
hospital in Kuwait. PLoS One, 14(5), e0217023. doi: 10.1371/journal.pone.0217023
Parks-Savage, A., et al. (2018). Prevention of medical errors and malpractice: Is creating
resilience in physicians part of the answer? International journal of law and
psychiatry, 60, 35-39.
Salah, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A
qualitative study. International Journal of Africa Nursing Sciences, 13(111), 100235.
doi:10.1016/j.ijans.2020.100235
Tsiga, E., Panagopoulou, E., & Montgomery, A. (2017). Examining the link between burnout
and medical error: A checklist approach. Burnout Research, 6, 1-8.
Wondmieneh, A., et al. (2020). Medication administration errors and contributing factors among
nurses: A cross-sectional study in tertiary hospitals, Addis Ababa, Ethical. BMC Nursing,
19(4). doi:10.1186/s12912-020-0397-0
Yousef, N., & Yousef, F. (2017). Using total quality management approach to improve patient
safety by preventing medication error incidents. BMC Health Services Research, 17(621).
https://doi.org/10.1186/s12913-017-2531-6