Medication Errors in the Emergency Department - Case Study Example

Methodology Research Design The study focusses on the issue of medication errors in Oman hospitals with a specific emphasis on the nurses’ perception on the various causes of medication errors. Since the study aims at understanding the various nursing experiences, it will employ a qualitative research design specifically a phenomenological study. Munhall (2012, p. 136) explained phenomenological studies as useful in understanding the lived experiences of a certain population group. In the study, the phenomenological design was employed to gain an understanding of what nurses perceive to be the cause of medication errors, by looking into lived experiences of the nurse. Nurses perform different roles in promoting health including the administration of drugs; therefore, the need to investigate their lived experiences; therefore, determine the factors likely to result in medication errors. Employing a phenomenological study will be beneficial for the study as it will allow an understanding of medication errors from the perspective of individuals who are in the front line of care delivery. A phenomenological study will also help in understanding nurses’ opinions on what can be done to curb issues of medication errors. As nurses act as the main care providers, there is also need to learn what they may presume as solutions to medication errors. Setting The study aims at understanding the factors that can lead to medication errors in emergency departments in Oman hospitals. Since the study aims at understanding nurses’ perceptions on what they consider as being the leading causes of medication errors, potential study participants will mainly come from emergency departments in Oman hospitals. The emergency department counts as one of the busiest within hospitals; therefore, a perfect site to get study participants due to their numerous experiences with medication errors. Population and Sampling The study seeks to understand the various causes of medication errors in emergency departments; therefore, will employ nurses from different emergency departments as the sample population. The sample population will consist of 50 emergency room nurses picked from various emergency departments in Oman hospitals. Emergency departments are usually very busy and involve dealing with different cases, which may result in medical errors. Emergency room nurses were mainly chosen as the sample population as they are the ones who are mostly tasked with the medication administration; therefore, the most likely to be blamed for the various errors. Qualitative studies aim at gaining a deeper understanding of a particular phenomenon which results in the use of a small population size (Dworkin, 2012, p. 1319). The small sample size will allow efficiency in gathering data on the causes of medical errors in Oman hospitals. The study will mainly employ a non-probability sampling method namely purposeful sampling technique. Qualitative studies aim at understanding the experiences of a specific population group; therefore, requires the sample to be deliberately selected to ensure information retrieved is relevant to the study (Ritchie and Lewis, 2013, p. 78). Employing a non-probability sampling technique requires the consideration of the population’s characteristics as the main tool in sample selection. The study will specifically employ purposeful sampling techniques. Ritchie and Lewis (2013) explained purposeful sampling to involve choosing participants with specific characteristics, which in this case is nurses working in emergency departments. The use of purposeful sampling allows for a detailed examination of the phenomenon as well as a clear understanding of the themes. Purposeful sampling also promotes diversity in the sample, which promotes in-depth understanding of the phenomenon due to diverse experiences from the sample. The sample population will mainly consist of nurses working in emergency departments in three Oman hospitals. All the study participants are aged 18 and above with the oldest participant expected to be 50 years old. The sample will consist of both male and female nurses working in the ER. Medication errors may affect both novice and experienced nurses; therefore, the sample will be composed of both novice nurses and highly experienced nurses. New nurses will help provide information on the most likely reasons for errors while experienced nurses will give information on what can be done to help reduce medication errors in the emergency department. The inclusion criteria will mainly include previous or current employment in the emergency department. The exclusion criteria include nurses working in other departments other than the emergency room. The study will be conducted in Sultanate of Oman, in Muscat, and will use one office in the hospital as the main data collection point. Data collection and analysis will be conducted between June and September 2016, with data collection occurring between June and July 2016. I work as a staff nurse at the hospital; therefore, gaining access to the research site for the specified period may not be that challenging. Data collection methods and procedures The study aims at understanding the various factors that may result in medication errors within emergency departments in Oman hospitals. The study will mainly employ semi-structured interviews as the most important instrument in data collection. Englander (2012, p. 14) explained that researchers employing the phenomenological design may conduct interviews as ways of understanding the participants opinions about a phenomenon. Interviews have several advantages including the ability to observe the participants non-verbal cues, as well as increased interaction with the participants. The use of open-ended interviews, allows participants to explain issues in a deeper context as their answers are not restricted to yes or no. The use of interviews also allows for diverse opinions; therefore, in-depth understanding of the phenomenon under study. The interviews will mainly be administered during a period of two months with each interview being expected to last approximately 45 minutes. As the main researcher, I will conduct the interviews with the different participants. Before conducting the interview, the researcher will first explain the main aim of the study as well as the benefits likely to arise from the study. Recording of the various responses will occur as the interview progresses. Recording of the replies will employ both an audio recorder and notebooks. The sound recorder will ensure no information is missed. The notebook will mainly be used to record key details about the interview, including non-verbal cues exhibited by the interviewee, as well as general comments about the interview. Using both the notebook and tape recorder will ensure a smooth data analysis procedure. The use of interviews may, however, result in reliability issues emerging especially due to lack of consistency. Leung (2015) explained five main strategies for improving a qualitative study's reliability. According to Leung (2015), the use of refutation analysis, tables, and constant data comparison promoted reliability in qualitative research studies. In the study, the reliability of the instrument will mainly be determined by constant comparison of information received during the interviews. This constant comparison will help ensure consistency of data collected; therefore, ensure a smooth data analysis process. Interview transcripts will provide a description of what the different nurses presume to be the main factors resulting in medication errors in the emergency department. Employing interview transcripts will also allow the different nurses to explain how they may react to instances of medication errors, including their perceptions of the hospital policy on medical error reporting. The researcher will employ the interview responses and observations, to make meaning to the data collected. Other than interviews, the research will also make use of secondary sources including Oman hospital statistics. The study will employ statistical data on medication errors in Oman hospitals, as a source of background data on the issue. The use of statistics will also help to provide a vague idea of the various factors that may result in medication errors, as well as provide an understanding of nurses often react during medication errors. Other than statistics the study will also employ internet sources and literature on past research on medication errors. Although there is limited literature on medication errors in Oman, the study will use literature from other developed countries as a way of understanding the various steps that have been implemented to reduce cases of medication errors. The use of statistics and past literature on the issue as secondary sources will help to provide an early understanding of the phenomenon, before conducting the interviews. Data Analysis The data analysis will employ a thematic content approach, which involves the identification and categorization of emergent themes. The process of data analysis will first involve transcribing the interview word-for-word (Elo et al., 2014). The transcribing process is likely to make us of both transcribing software and manual transcribing; therefore., ensure all information in the audio responses was transcribed (Tesch, 2013). After transcribing, the researcher will go through the interview transcripts, which will allow identification of recurrent themes in a process referred to as coding. Coding will make use of self-memos and summaries. These two tools will help in recording of the researcher’s ideas regarding the various ideas emerging from the study The third step of the data analysis will involve a comparison of words and phrases from all interviews, in a bid to eliminate redundant information. This process will help in identification of the repetitive theme. Verification of Collected Data.  The verification of data collected will contribute to reducing bias as well as ensure the analysis is rigorous. The process of data verification will involve asking the study participants to validate the data, and analysis, as well as the use of peer review to ensure the reliability of the results. The first step in data validation will involve approaching the study participants and asking them to read the interview transcripts and analysis; therefore, validate or refute how the researcher interpreted the data. The process of participant validation is, however, time-consuming and should be conducted as soon as the analysis is complete. Conducting a participant validation right after the analysis prevents study participants from changing their perceptions regarding the medication errors in the emergency department. The other validation process involves peer review. The peer review process involves a different researcher reviewing and going through research data; therefore, refute or validate the data interpretation. The peer review process helps prevent lone researcher bias, as well as provide insights on the themes identified in data. Ethical considerations The study aims at exploring the various factors that may result in medication errors in emergency departments in Oman hospitals. One major ethical issue likely to arise from the study is that of getting the research site. The research site is in a hospital in Oman; therefore, need to seek permission from the management to use the premises. Seeking permission will involve writing a letter to the hospital’s management, informing them of the research purpose. Other than seeking permission, there is need to ensure confidentiality of the participants. Data recording will not involve the mention of participants names, but will make use of numbers to refer to the participants. Another ethical principle to consider in the study is that of informed consent. Informed consent will involve informing the study participants all information regarding the study, including the benefits of the study. Participants will have the right to withdraw their participation if they do not feel comfortable. The study will also need to seek approval from the Ministry of health. Limitations The study will face several limitations including a limited number of participants, which may limit the generalization of data. The study will employ a sample from three Oman hospitals located in Muscat. The study results may only reflect factors affecting hospitals in Muscat, and not hospitals in other areas. This limitation calls for future research on the issue to incorporate nurses from different areas in Oman. References Dworkin, S. L., 2012. Sample Size Policy for Qualitative Studies Using In-Depth Interviews. Archives of Sexual Behavior, Volume 41, pp. 1319-1320. Elo, S. et al., 2014. Qualitative Content Analysis: A focus on Trustworthiness. Sage Journals. Englander, M., 2012. The Interview: Data Collection in Descriptive Phenomenological Human Scientific Research. Journal of Phenomenological Psychology, Volume 43, pp. 13-35. Leung, L., 2015. Validity, reliability, and generalizability in qualitative research. Journal of Family Medicine and Primary Care , 4(3), pp. 324-327. Munhall, P. L., 2012. Nursing research: a qualitative perspective. Sudbury, MA: Jones & Bartlett Learning. Ritchie, J. & Lewis, J., 2013. Qualitative Research Practice. London: Sage Publishers. Tesch, R., 2013. Qualitative Research: Analysis Types and Software. Abingdon: Routledge. Read More