The Aspects of Dermatology - Research Proposal Example

Research Proposal for CIHR Grant Background In dermatology, drug administration errors were common and a study byBerdot et al. (1-4) suggest that the error rate of 27.65 was found, but this decreased to 7.5% after excluding the wrong time errors. However, the study further suggests that 94% of the errors were unlikely to cause substantial harm, but 6% could cause potential and severe harm to the patient. Berdot et al. (1-8) further show that the factors associated with the errors include the administration route and drug ATC, including the number of patients managed by a single nurse. Alternatively, the preparation of unit-dose by the hospital did not show any association with a high incidence of errors, when compared to the removal of drugs from a secured cabinet in the hospital. A study by Dibbi et al. (1491) supports the study conducted by Berdot et al. (1-8) in the context that drug administration was the most common error in dermatology. The study showed that the wrong route of administration was prevalent, including administration of improper dosage to the patients. Another study suggested that administration of wrong dosages was the most common error, followed by administering the incorrect drug, and lastly the wrong route of administration. Weyers (29) on the other hand, conducted a study, which shows that specimen mix-up is a common error in dermatology. It has been a significant error across the countries in the globe and there are only few cases presented. A survey conducted in different hospitals across the globe showed that the incidence of specimen mix-up was about 0.5%. In most of the cases, the errors varied, and in one instance, surgeons reported on missing or incorrect data of patients on the different samples or forms. In other cases, surgeons found incorrect correlation of the sample bottles and request forms. In such, the prevalent cases included missing numbers on bottles that contained biopsy specimens from the patient. However, it was also possible or rather reported that there were special cases whereby the surgeons could not find the biopsy specimens or the sample bottles altogether. Some of the errors noted are simple, and many of them result due to the pressure the staff is through during their work (Suvisaara & Sryjala 1133-1135). Research is yet to show the extent, or rather the underlying factors that induce human errors in such a critical field of healthcare. It is essential to address the issues that may be contributing to the errors seen in this area of healthcare. Poor communication among the healthcare providers is one of the significant challenges, and likely to induce potential errors. In dermatology, missing, incomplete, or illegible entries on the request forms are prevalent and this provides an insight on the importance of systematic inquiries. Therefore, among many other objectives of this study is to address the causal factors of human errors, which in turn induce errors in the dermatology field. Summary Since the report To Err is Human, patient safety has become vital in healthcare issues. It is likely for medication errors to happen during any of the three-medication process, which are prescription, dispensation, and administration. There are substantial literatures that report on the three stages of care. Evaluation and improvement in the care stages are the main aspects in safety of the patients. In the dermatology field, surgeons have been attempting to find ways to eradicate discomfort experienced by patients after dermatologic procedures. Surgeons use local analgesia to relieve pain, but some of the dermatologic procedures are extensive, which make them require intravenous or general anesthesia (Yag-Howard & Faad 1660-1661). Some of the methods used to achieve injection of anesthesia are an anesthetic solution of lidocaine, tetracaine, chloroprocaine, etodicaine, or chloroprocaine with or without epinephrine, around the surgical area, and many other techniques. Nonetheless, the dermatologists prefer using an injection of a mixture of licodaine and epinephrine around the surgical area. They prefer this because it achieves anesthesia, making the subsequent invasive procedures pain free; however, the initial needle stick and infiltration of anesthetic agent inflicts some degree of pain to the patient. Nonetheless, the most important issue is the errors that occur in dermatology, and their adverse effects on the patient. This study will follow an evidence-based approach to acquiring empirical results, which will provide the issues that induce errors in the dermatology. As stated earlier, some of the errors arise due to lack of following instructions, but this also arises due to other factors, particularly human factors. The human factors vary, and some of them are because of work pressure. Another objective of this study is to identify the barriers for error disclosure in dermatology. These are among the things that make this study important. Many of the prior studies have provided the general information on medical errors in the medical field but have not paid attention to the area of dermatology. Therefore, using the evidence-based approach, this study will be exceptional considering the lack of an empirical literature, or rather studies on the area of dermatology (Sirota 1230). Hypothesis Apparently, there are errors in the medical field, and they vary according to the area of health care provision. Research on errors in dermatology has not been successful due to many barriers that influence disclosure of information concerning the errors. In addition, the staff often works under pressure, which is one of the underlying factors that contribute to medical errors in the dermatology. This is not conclusive because human errors also play a role in contributing to most of the errors (Sobanko et al. 709-721). Using this information, I will formulate a hypothesis for this study. Hypothesis 1: There are barriers to information disclosure in dermatology Hypothesis 2: Human errors are contributing factors to errors in dermatology Methods Survey This study will include a wide variety of samples to achieve unbiased information, and different information to allow for generalization if appropriate. Some of the samples will be from within the country, but others will be continents away. The survey will include a self-completed questionnaire with questions, which seek to know the underlying human factors that contribute to potential errors in dermatology. The questionnaire will also seek to identify reasons as to why the staff fails to share information on errors in dermatology (Berdot et al. 4-8). The survey will use various approaches owing to the geographic location of the participants. Participants within the country will provide face-to-face information, but those overseas will use mailed surveys. In addition, the study will also include online surveys. Recruitment After approval from the ethics board, the study will focus in one of the dermatology clinics. The study will take place in Cleveland Clinic, which is in Cleveland, Ohio. The clinic is among the many clinics that offer dermatological services, making it a good choice for a sample within the country. The study will also include The University of Texas Medical School Resident Clinic, which also offers dermatological services, in the same country, but different states. The study will also include a UK-based sample from the Cancer Research UK. The samples chosen will provide a wide variety of responses to allow for subsequent analysis of date, and arrive at conclusions. Data Analysis The survey will utilize online surveys, mailed questionnaires, and face-to-face interviews, which means that most of the collected data is descriptive. Using the descriptive approach will create confusion for the reader. Therefore, the study will follow the one-way table analysis. In so doing, all the large information, or rather responses from the surveys will appear on the table. In addition, one-way table will allow for easy tabulation of results, question by question, which will make it easy to draw conclusions. Afterwards, it is easy to get the measure of central tendency by using the frequency of participants who gave similar responses. The method does not need to show the participants who gave a particular response. Pitfalls In dermatology, individual human errors caused by a short moment of abstraction of the staff in the biopsy pathway are inevitable, considering the many patients and the many specimens that the staff takes from the patients (Yag-Howard & Faad 1661). Therefore, it is imperative to make sure that people or rather the staff in the dermatology is concentrating on their main roles. This is achievable through sufficient rest periods and a quiet working environment. In addition, it is important to avoid interruption in the setting particularly because this can induce memory lapse, which is a contributing factor to the human error. In the event of interruption, the staff should continue working, and later on respond to the request after completion. Significance This study will be essential, particularly because it will provide the wide variety of errors that may occur in dermatology, which the staff fails to disclose. In addition, it will provide critical information on the causal factors of human errors, which in turn result into most errors in dermatology. This will add to the existing body of research in the medical field, particularly studies on dermatology. In addition, it will make the readers gain an insight of how the working environment can be influenced by human factors, which can induce medical errors (Dibbi et al. 1489-1491). Knowledge Transition One of the successes of research is making the study reach a large audience. However, there are many problems when trying to transfer this knowledge gained from research. One of the things to do to ensure that the knowledge gained reaches a large audience, is making the study accessible online. The study will be one of its kinds, and this will attract a large proportion of publishers, who will further help in distributing the research to potential readers. The study will be provided free of charge, putting in mind that facilitation in terms of funds came from grants; therefore, there is no need to sell the research material. Investigator Skills The investigator has conducted numerous studies, which range from a wide variety of topics. Most of the studies have reached a large audience worldwide. The investigator has also worked with several other investigators and provided substantial knowledge in a wide variety of areas. The author has conducted studies using various approaches and applying a wide variety of research methods. Therefore, the investigator is well-acquainted with research methods, and the processes that entail successful investigations. Since the year 2004, the investigator has carried out researches on various topics, and published over 100 studies, with various publishers. Investigator Roles The investigator alone will conduct this study. The investigator will be liable for all the research provided, including subsequent potential queries that readers may have. This will also include adhering to the ethical guidelines provided by ethical boards. Another responsibility is the scientific integrity of the entire study. In a case there are other helpers or co-investigators, the investigator will supervise the progress of the study, and ensure that the opinions of the investigators do not appear in the study. Therefore, the investigator will ensure that the data in the study will reflect the participant’s responses only. Ethical Considerations This study will comply with the outlined ethics from the relevant ethical boards. The study will not provide the participant’s names, or other personal information, whether verbally or in print to the public. In addition, the study will provide the participants will the correct intents of the research prior to taking part. Before everything else mentioned on this section, the researcher will provide all the details of the study to the National Health Service for approval (Berdot et al. 1-8). In addition, this study does not pose any risk to the participant, but the study does not overrule the possible psychological risk in particular cases, especially where a staff made an error that resulted to death of a patient. Financial Support Some medical organizations have facilitated this research by providing funds to carry out the entire investigation. The ONS foundation provided $15,000, which will help in purchasing the relevant materials for research. The money will also help in printing the materials and using the internet to host an online survey program. The money will also help to make phone calls both abroad and locally to verify if the participants have received the questionnaires, and to seek to know if they understand the information on the questionnaires. In addition, it is likely that the investigator will make several trips to seek approvals. The money will cater for the trips, and pay the co-investigators and the investigator. Works Cited Berdot, Sarah et al., “Evaluation of drug administration errors in a teaching hospital,” BMC Health Sciences Research, 12.6 (2012): 1-8. Print. Dibbi, Huda et al., “Causes and outcomes of medication errors in hospitalized patients,” Saudi Med J, 27.10 (2006):1489-1492. Print. Sobanko, Joseph F., Christopher J. Miller, and Tina S. Alster. "Topical Anesthetics For Dermatologic Procedures: A Review." Dermatologic Surgery 38.5 (2012): 709-721. Academic Search Premier. Web. 1 Apr. 2014. Yag-Howard, Cyndi, and Faad M. D., “Commentary: A Prospective Comparison Between Neutralizing the pH of 1% Lidocaine with Epinephrine (Buffering) and Pre-Operative Skin Cooling in Reducing the Pain of Infiltration of Local Anesthetic,” American Soceity of Dermatologic Society, 38, (2012): 1660-1661. Print. Sirota, Ronald, “Error and error reduction in pathology,” Arch Pathol Lab Med, 129.10 (2005): 1228-33. Print. Suvisaari, Janne, and Syrjala Martti, “Practical method for estimating the fre­quency of specimen mix-up in clinical chemistry laboratories,” Clin Chem., 48.7 (2002):1133-5. Print. Weyers, Wolfgang, “Confusion-specimen mix-up in dermatopathology and measures to prevent and detect it,” Dermatology Practical Concept, 4.1 (2013): 27-42. Print. Read More