NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

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Capella university

NURS-FPX 5005 Introduction to Nursing Research, Ethics, and Technology

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Date

Introduction

Patient safety and reducing Medication Errors (MEs) are among the primary concerns in healthcare. Emerging patient care technologies, one of which is called Barcode Medication Administration (BCMA) systems, have so far been crucial in reducing MEs and improving outcomes related to high-risk settings, one of which is a critical care environment. MAE remains one of the most significant threats to healthcare providers since it can further cause AEs or even death.

General solutions are, however, not adequate without focused approaches that involve Evidence-Based Practices (EBPs) (Worafi, 2020). This paper will discuss the criteria and processes for EBP, the role of scholarship and information in nursing practice, and the ethical and regulatory implications of implementing BCMA systems. It looks at a systematic plan for the implementation of BCMA in clinical settings, focusing on how to align the technology with regulatory standards and ethics in patient care.

EBP Criteria and Processes

An EBP incorporates the integration of clinical expertise, patient preference, and the best available research evidence for improving patient outcomes. This systematic process means that nursing decisions should be based on science at all times. The steps in development start with formulating a clinical question. This can be achieved using the PICOT format: Population, Intervention, Comparison, Outcome, and Time. Following the formulation of the question, a search is conducted to retrieve the evidence from peer-reviewed studies. The third level is a critical appraisal of the evidence for validity and applicability (Dang et al., 2021, p. 384).

The application of evidence then follows in clinical practice, which also considers patient preferences and organizational resources. Finally, the review of outcomes ensures the intervention accomplishes what it is supposed to and indicates those things that may need further refinement. Criteria such as strength of evidence, correspondence to clinical guidelines, relevance to patient needs, and feasibility in the healthcare environment are important criteria in developing EBPs. However, challenges also exist in the EBP development processes, including access to good research that might be limited, resistance to change from staff, and pressures on time in the clinical setting. Overcoming these challenges requires leaders, continued education, and a culture promoting evidence-based practices (Dang et al., 2021, p. 384).

Scholarship and Information in EBP

EBP of nursing includes effective scholarship and access to reliable information. Nursing scholarship refers to the pursuit, generation, dissemination, and application of knowledge. It enables nurses to stay updated with the changes in research, best practices, and continual improvement in the patient’s outcomes. The development of EBP is driven by scholarly inquiry that fills the gap between theory and clinical application, making nursing intervention evidence-based and not based merely on tradition or intuition. The role of evidence and scholarship in developing EBP is foundational. It is the evidence from peer-reviewed research studies, clinical guidelines, and systematic reviews that forms the backbone upon which EBP was built (Cullen et al., 2022).

Scholarship allows nurses to critically appraise studies and determine the appropriateness of interventions for their setting. This approach generates innovation in clinical practice but, at the same time, can ensure patient safety and assure high-quality care (Cullen et al., 2022). A number of key criteria provide the basis upon which evidence is assessed for quality and its applicability in clinical practice. Credibility and reliability are that the source has to be from a peer-reviewed journal or an authentic database, provided recognized experts in the same field have highly scrutinized the research.

NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

Relevance is the evidence must also be relevant in the specific clinical setting and the patient population and should be relevant in the context in which the intervention would be used. Validity and rigor form the most integral parts. It involves the verification that the research was performed by using the correct methodology. It consists of the use of a proper study design, sample size, and statistical analysis, among others, to ensure that the findings can be valid and reproducible (Schmidt & Brown, 2024, p. 650).  

Finally, timeliness is considered because health is a dynamic field, and practices held some time in the past may not apply now. Evidence, in this regard, should ideally have been recently published within the last five years in order to reflect the current best practices and advances within the profession. Separately and collectively, these features guarantee only reliable, high-quality, and relevant evidence that informs nursing practice in efforts toward effective decision-making that improves patient outcomes (Shaker et al., 2020).

These criteria ensure that practice decisions are informed by nothing but high-quality evidence. Good scholarship will allow nurses to arrive at well-informed decisions. It will enable them to take up emerging needs for healthcare and stand in a position to continue offering their care based on the best available evidence, translating into better patient results (Schmidt & Brown, 2024, p. 650).

EPB Clinical Question

The clinical question selected is: How can the use of BCMA systems reduce ME and improve patient safety within a critical care unit? This question focuses on how BCMA technology can prevent MAE, a very critical problem in health care that results in serious patient harm or death. The BCMA systems recognize patient identification, medication identity, dosage, and time of administration through barcodes, ensuring that the appropriate drug is provided to the appropriate patient at the proper time. This technology provides an active strategy for the reduction of human errors in minimizing nursing workflow efficiency and improving the safety of patients in high-risk critical care (Abdelaziz et al., 2024).

In conducting the literature search, a great article by Mohanna et al. (2021), outlines the impact BCMA systems have in relation to medication safety. The study researched the utilization of implementing BCMA to reduce the occurrence of MEs in a hospital’s ICU. Results showed there was a significant decrease in the MAEs for cases involving wrong dosages and missed medications. According to the article, staff resistance to technology, workflow disruption, and intensive training for proper use were some of the challenges put to light. It underlined a number of knowledge gaps and uncertainties. For example, it indicated how studies are needed to extend the time effects of BCMA on nursing efficiency and patient outcomes.

NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

There is also scant literature that may guide the optimum integration of BCMA with other health information systems for streamlining clinical workflows. The article also pointed out that while BCMA decreases some types of errors, it does not eradicate all types and thus raises questions about other mechanisms for safety that might complement this technology. Fully exploiting these potentials of the BCMA system in a critical care setting involves creating sustainable change in patient safety, and this needs to be explored through further research to address such knowledge gaps (Mohanna et al., 2021).

Technology and Ethical/Regulatory Implications

There are a number of ethical and regulatory concerns regarding BCMA in a critical care setting. The ethical aspect is the fact that regarding BCMA, patient safety is the main issue to consider, which would prevent MEs that may harm patients. Ensuring the accurate administration of medications supports the ethical principles of beneficence- promoting the well-being of the patients- and non-maleficence- not causing harm to the patient. Some problems to be overcome include resistance by staff, overdependence on technology, and interference with workflows, all of which may interfere with attention to the patient.

The principle of autonomy and compliance with privacy regulations, such as the Health Insurance Portability and Accountability Act (HIPAA), may be satisfied by ensuring that the patient’s personal and medical data is kept confidential in the event of using barcode scanning. Another regulatory requirement is compliance with standards set by bodies such as the Joint Commission and the Food and Drug Administration, which requires health organizations to observe standards for medication safety and technology application. Proper documentation, staff training, and regular audits will also be important for ensuring the effective and consistent usage of the BCMA system (Hughes, 2021).

NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

Various steps are to be followed in the implementation plan of the BCMA systems within a clinical agency. First, there will be engagement with stakeholders by ensuring that nursing staff, pharmacists, and IT teams are involved right from the very start to enhance buy-in and reduce resistance. Full training programs will be provided to ensure that staff can use the system without compromising patient care  (Abdelaziz et al., 2024).

A pilot phase will allow for the identification and resolution of workflow challenges. Secondly, the system will be audited on a continuous basis in order to comply with the regulatory standards and to achieve maximum efficiency. Lastly, continuous quality improvement analysis shall be implemented, whereby the input of the staff shall be taken into consideration to meet all ethical issues and improve the system’s performance. In this way, a stepwise approach would definitely ensure safe, ethical implementation of the BCMA system, which will also be compliant with regulatory requirements  (Abdelaziz et al., 2024). 

Conclusion

Implementing BCMA systems in critical care units is essential for reducing MEs and enhancing patient safety through evidence-based practices. While BCMA offers a proactive solution to mitigate human errors, challenges such as staff resistance and workflow disruptions require thoughtful strategies for seamless integration. Adhering to ethical principles, regulatory standards, and continuous quality improvement ensures the successful and sustainable implementation of this technology in clinical settings.

References

Abdelaziz, S., Amigoni, A., Kurttila, M., Laaksonen, R., Silvari, V., & Franklin, B. D. (2024). Medication safety strategies in European adult, paediatric, and neonatal intensive care units: A cross-sectional survey. European Journal of Hospital Pharmacy. https://doi.org/10.1136/ejhpharm-2023-004018 

Cullen, L., Hanrahan, K., Farrington, M., Tucker, S., Edmonds, S., & Tau, T. (2022). Evidence-based practice in action: Comprehensive strategies, tools, and tips from University of Iowa Hospitals & Clinics. Sigma Theta Tau International. https://books.google.com.pk/books?hl=en&lr=&id=QU5-EAAAQBAJ&oi=fnd&pg=PP1&dq=Evidence-based+practice+in+action:+Comprehensive+strategies,+tools,+and+tips+from+University+of+Iowa+Hospitals+%26+Clinics.+Sigma+Theta+Tau+International.&ots=LWDJfd5qdz&sig=ZrPdh_F4ayyezCO-N_udJEap6LE&redir_esc=y#v=onepage&q=Evidence-based%20practice%20in%20action%3A%20Comprehensive%20strategies%2C%20tools%2C%20and%20tips%20from%20University%20of%20Iowa%20Hospitals%20%26%20Clinics.%20Sigma%20Theta%20Tau%20International.&f=false 

NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model & guidelines (4th ed., p. 384). Sigma Theta Tau International.  https://books.google.com.pk/books?hl=en&lr=&id=m4k4EAAAQBAJ&oi=fnd&pg=PP1&dq=development+of+an+evidence+based+practice,+how+to+develop+a+practice&ots=pVKzDCz7xg&sig=7RnvOtbkJ0yRyX9eXluPyQljuzQ&redir_esc=y#v=onepage&q=development%20of%20an%20evidence%20based%20practice%2C%20how%20to%20develop%20a%20practice&f=false 

Hughes, T. (2021). Ethical conflicts and legal liability in professional nursing. The Medical-Legal Aspects of Acute Care Medicine, 393–415. https://doi.org/10.1007/978-3-030-68570-6_18 

Mohanna, Z., Kusljic, S., & Jarden, R. (2021). Investigation of interventions to reduce nurses’ medication errors in adult intensive care units: A systematic review. Australian Critical Care, 35(4), 466–479. https://doi.org/10.1016/j.aucc.2021.05.012 

Schmidt, N. A., & Brown, J. M. (2024). Evidence-based practice for nurses: Appraisal and application of research (6th ed., p. 650). Jones & Bartlett Learning. https://books.google.com/books?hl=en&lr=&id=E7XnEAAAQBAJ&oi=fnd&pg=PP1&dq=development+of+an+evidence+based+practice,+criteria+to+evaluate+the+evidence&ots=FOwyEEEa05&sig=pT127UHjmjuDQSeyuC_ABhxS3nQ#v=onepage&q=development%20of%20an%20evidence%20based%20practice%2C%20criteria%20to%20evaluate%20the%20evidence&f=false 

NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

Shaker, M. S., Wallace, D. V., Golden, D. B. K., Oppenheimer, J., Bernstein, J. A., Campbell, R. L., Dinakar, C., Ellis, A., Greenhawt, M., Khan, D. A., Lang, D. M., Lang, E. S., Lieberman, J. A., Portnoy, J., Rank, M. A., Stukus, D. R., Wang, J., Riblet, N., Bobrownicki, A. M. P., & Bontrager, T. (2020). Anaphylaxis—a 2020 practice parameter update, systematic review, and grading of recommendations, assessment, development and evaluation (GRADE) analysis. Journal of Allergy and Clinical Immunology, 145(4), 1082–1123. https://doi.org/10.1016/j.jaci.2020.01.017 

Worafi, Y. M. A. (2020). Medication errors. Drug Safety in Developing Countries, 59–71. https://doi.org/10.1016/b978-0-12-819837-7.00006-6