1. Medication Errors and Staffing Ratio Barlow Bird, Cindy Olsen, Judy Wilkin, Loran Greenwall, Sarah Williams Methodology CLINICAL QUESTION CONCLUSION Evidence PICO REFERENCES Population: registered nurses working in long term care facilities Intervention: higher nurse-to-patient ratios Comparison: low nurse-to-patient ratios Outcome: decreased incidence of medication errors in the long term nursing facilities Study One A literature review of more than 9 studies and findings was done. There were common themes that were identified as causes of medication errors. They reason for errors ranged from things such as distraction to bad physician hand writing. The results of this review did not answer our specific question as to whether nursing staff ratio in long term facilities has an effect on medication errors. More clinical research will need to be done regarding our question. Study Two “The purpose of our study was to examine the relationship between nurse staffing and the occurrence of medication errors on medical-surgical units” (Firth, p. 289). This article did a convenience survey of 9 hospitals and found that it difficult to record results or medication errors because of staffing and lack of reporting errors. The conclusion was that more research needed to be done to find out if nurse staffing effects medication errors. Our clinical question was not addressed, more research needs to be done. Study Three This article was a literary review done by Mahmood, Chaudhury, and Gaumont. The purpose of which was to find out if environmental factors contributed to medication and nursing errors in long term facilities. Some of the environmental issues related to medication and nursing errors were: We were specifically concerned about staff to patient ratios and medication errors. They determined that staff shortage was a contributing factor in medication errors. Their findings show that environmental factors and staff shortages are related. More research regarding staff ratio and medication errors will have to be conducted. Study Four This was a double-blind peer-reviewed study to identify factors that contribute to repeat medication errors, and whether they pose more harm to the residents of nursing homes. Candidates used in the study were chosen by willingness to participate and involved 294 community-based nursing homes in North Carolina and Massachusetts. Factors that contribute to repeat errors were not identified, but repeat errors were identified as common and a much greater threat to residents’ health than single administration errors. This article shows detailed information on the incidence of medication errors and their adverse effects on patients in nursing homes, but is not directly related to our research question, so this article is of low relevance. Does nurse to patient ratio effect medication errors in long term care facilities? Our research aims were to determine if low nurse to patient ratios contribute to more medication errors. Based on our research, we have concluded that there are many reasons for medication errors. However, more research needs to be done in long term nursing facilities that focuses on the nursing staff ratio to medication errors. Having this research will answer our specific evidenced based question. The purpose of this project was to conduct an evidenced based practice research project examining a clinical question of interest. Hewitt, P. (2010). Nurses' perceptions of the causes of medication errors: An integrative literature review. Medsurg Nursing,19(3), 159-167. --------------------------------------------------------------------- Frith, K. H., Anderson, E., Fan, T., & Fong, E. A. (2012). Nurse Staffing Is an Important Strategy to Prevent Medication Errors in Community Hospitals. Nursing Economics, 30(5), 288-294. --------------------------------------------------------------------- Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50. --------------------------------------------------------------------- Mahmood, A., Chaudhury, H., & Gaumont, A. (2009). Environmental issues related to medication errors in long-term care: Lessons from the literature. HERD : Health Environments Research & Design Journal, 2(2), 42-59. Based on our preventative question the following terms:“long term care facilities”, “nursing staff ratio”, “medication errors” were searched in the following internet sites and databases: EBSCOhost, PROQUEST, CINAHL, and Elsevier PURPOSE Study Five “This article gave insight to medication errors by addressing topics such as knowing about medications errors, their process and possible solutions to prevent medication errors. It had little relationship to our clinical question. More research will need to be done.