The article Empowering Frontline Nurses: A Structured Intervention Enables Nurses to Improve Medication Administration Accuracy mainly focuses on the precautionary safety measures that should be adhered to when providing patients with the medications. The primary area of interest was to improve the accuracy with which drug is administered to patients through the development and deployment of process improvement skills and nurse leadership in a surgical inpatient unit. Medical errors have always taken a toll on the quality of services that patients receive in most hospitals. Such errors have long been documented in the form of surveys and studies. The harmful effects associated with these errors come in the form of deaths in the United States with statistics indicating that close to 7,000 deaths occur yearly(Kliger et al., 2009). These deaths can are prevented if the necessary precautions are taken to address them.
There are several independent variables in this study including the comparison of medication administration records to the medication taken, two patient identifications, charting medication information after administration, protecting the process from interruptions and distractions, proper explanation of drugs to patients and appropriate labeling of medications (Kliger et al., 2009). These independent variables can be summed up to form one comprehensive variable referred to as improvements in the work environment. The dependent variable is the accuracy in medication administration.
Extraneous variables are the ones that may influence the relationship which exists between the dependent and the independent variables in the experiment thereby affecting the outcomes of the study. These variables may positively affect the results of the survey although they were not intended for the said purpose (Munhall, 2012). In this study, the technique with which the medication is administered has influenced the results of the experiment. More succinctly, there were some cases where wrong drug administration technique errors occurred for instance in situations where a particular medication that was meant to be administered on a free stomach was instead administered concurrently with food, the levels of errors decreased from forty-one errors to just five errors in the 18-month experiment period (Kliger et al., 2009). As it can be seen, the variable (wrong administration technique) may have influenced the outcomes of the study even though it was not of interest. The remedy for this problem is making sure that the nurses responsible for administering the medication stick to the required administration technique. Such a move serves the purpose of avoiding spurious relationships.
There are two probable sources of threats to the internal validity of this study. They are the testing and instrumentation threats. The pre-test that was conducted on the level of medication accuracy before carrying out the experiment may have had an impact on the outcomes of the study since the participants may have adjusted their routine care practices by the pre-test but not with the treatment of variables (Munhall, 2012). Secondly, instrumentation may pose a threat to the internal validity in the sense that, a change in the technique used for measurement may have resulted in the reduction of errors in medication accuracy but not necessarily in line with the objectives of the study.
Regarding external validity, the possible threat that can be identified is the realization that even though the research was carried out in seven hospitals in San Francisco, there will be problems in regards to generalization since the study participants are not representative of the whole United States’ population. As such, the inferences made from the experiment may be questionable. The remedies that can be done to avert the internal validity threat are by concealing the results of the pre-test from the participants to prevent them from adjusting their outcomes to suit the post-test results. Regarding instrumentation, it is essential that study participants stick to the correct technique while administering the medication in ensuring that the results are accurate (Robson & McCartan, 2016). The external validity threat can be solved through carrying out the study in a wider geographical area rather than concentrating on one state only.
References
Kliger, J., Blegen, M. A., Gootee, D., & O'Neil, E. (2009). Empowering frontline nurses: a structured intervention enables nurses to improve medication administration accuracy. - PubMed - NCBI. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20043500
Munhall, P. L. (2012). Nursing research. Jones & Bartlett Learning.
Robson, C., & McCartan, K. (2016). Real world research. Wiley.
