How Shift-Work Leads to Medication Errors among New Graduate Nurses

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Table of Contents

Chapter 1. 3

  1. Introduction. 3

1.1 Background of Study. 4

1.2 Purpose of Study. 5

1.3 Research Questions. 5

1.4 Objectives of Study. 5

1.5 Significance of Study. 5

Chapter 2. 7

2.1 Literature Review.. 7

2.2 Medication Administration. 8

2.3 Type of medication errors. 8

Chapter 3. 10

3.1 Research methodology. 10

3.2 Research Design. 11

3.3 Population of Research. 11

3.4 Data collection Method. 12

3.5 Data analysis. 14

3.6 Research Rigor 14

3.7 Ethical consideration. 15

3.8 Research Plan. 16

References. 18

Chapter 1

1. Introduction

Working in shifts is a reality for about 15% of United States working population. In the United Kingdom, 10% of the population have fixed hours out of the standard range, and 30% have uneven working hours, 5% work on shift schedules (Camiré, Moyen & Stelfox, 2009). The amount of all employees who work uneven working hours or night shift hours mainly allocated at night has doubled by more than thrice over the past ten years hence the number of medication errors has increased especially to new graduates.  In various countries, an eight-hour shift program or system has been implemented on collective and legislative bargaining. This has led to various problems in the administration such as medication errors

A trend towards working longer shifts of more than eight hours has also been adopted by these nations. Health care service is one of the industries that offer a continuous service, for the benefit of all the citizens in any nation (Camiré, Moyen & Stelfox, 2009). It is, therefore, anticipated that experienced and knowledgably workforce offer healthcare. United States nurses offer health services in clinics, hospitals, and other health centres in meeting health or medical demand of people. Nurses are bound to work shift-work as a health demand for several people in all countries.

Nurses are mandated to work during the day and at night to ensure the needs of the patients are met. This can be possible if the nurses work during the twenty-four hours a day. For several nurses, changes evident to nightshifts are unwelcome burden on ordinary life, yet they have no control over managing or avoiding the burden. Night shift has social, psychological, and physical effects on the life of a person including a nurse hence leading to medication errors. The long hours they work interfere with medication administration. Medication errors is even worse for female nurses who have household responsibility like child rearing and pregnancy. To the new nurses, these effects or medication errors are not only individual but are also could endanger patients’ lives.

  1.1 Background of Study

The emphasis of this paper will be concentrating towards getting the most-affordable recommendations that will reduce the risk nurses pose to patients because due to stress arising from shift stress and how it affects medication management leading to medication errors. The study will be conducted in two public hospitals. The two hospitals will be located in the province of Queensland. The hospitals tailor for the population within the city, including the neighboring suburbs (Campanelli, 2012). The major study will involve one hospital in which nursing personnel will be required to respond to a questionnaire that will be directed to the nurses working on both day and night shifts.  The second hospital will be included to explore the macro-ergonomic of this study since both the hospitals have identical administrative structures and procedures.

The new graduate nurses’ work in varied units of the hospitals, as allocated based on the hospital needs as well as their qualifications (Hansen et al., 2010). Nurses’ roles involve fulfilling of the nursing and medical demands of the patients, assigned to work on night and day shifts as per work plan. Some of the nurses in both the hospitals are permanently deployed to work on night shifts, a few of them on a rotational basis, and others work night shifts for a specified duration (usually 2 to three months).

With respect to the above workforce and the level of assignment designed to different shift schedules within the health care service, it will be important to conduct this study to determine the effects of night shift to medication errors among new graduate nurses.  The study should be able to offer directions as to the steps to be considered in order to reduce medication error caused by long working shift (Suh et al., 2012).

1.2 Purpose of Study

The general purpose of the study will be to identify the impact of night shift on new graduate nurses cause of medication errors and to determine the effects of this to the wellbeing and health of the patients, with the intention of creating a most-credible method of reducing such medication errors in the future.

1.3 Research Questions

  1. What are the factors that have both direct and indirect impacts on new graduate nurses’ lead to medication errors?
  2. Are there any recommended solutions to reduce the medical management causes of medication errors among new nursing graduates?

1.4 Objectives of Study

  1. To identify those factors that have both direct and indirect impacts on new graduate nurses’ lead to medication errors.
  2. To acclaim any recommended solutions to reduce the medical management causes of medication errors among new nursing graduates.

1.5 Significance of Study

The study will be important to the following organizations and individuals:

The Nursing profession and Nurses

The nurses will benefit from this research since their reporting and perceptions regarding medication errors would be addressed, therefore, their concerns will be addressed. The findings from the study will also be vital in addressing new guidelines to avoid medication errors and accelerate reporting procedures.

Future Researchers

This research will also act as a reference for future scholars and researchers who will ever conduct a research on medication errors.

Other Health Facilities Administrators

The administrators will also benefit from the study since they will be able to know the types of medication errors that new graduate nurses are prone to due to the extensive shift work.  Based on the results, they can revise their policies concerning shift work and medication errors.

Chapter 2

2.1 Literature Review

The issues of medication errors stated many years ago, and patients due suffer/die without good nursing care. The approach of this study is based in the belief that less experience and education lead to increased medication errors especially to new graduates. This is supported by proof that there is an increase in the number of medication errors causing individuals’ lives (Campanelli, 2012). Based on the above information, is it significant to determine or evaluate new nurse’s medication errors and the reasons why they make them and the preventative steps that can be taken to reduce the risk of making more mistakes.  There is limited research published correlating between experiences with the number of medication errors among new graduates.

Despite the fact that there are varies layers involved in medication administration, it the obligation of a nurse such as the new graduates who are responsible for medication errors. Advancement in medical science is noted to lead to an increase in both the potency and numbers of medications that are prescribed (Hansen et al., 2010).  According to Suh et al., (2012) study done in a twelve-month duration in England, he did a study whereby he used self-administered questionnaires about incident reports and medication errors. The sample size used was seventy-three.  The study indicated that more than half of the medication errors intravenous drug dosage related.

Medication errors accounted for 10,000 deaths in 2012 as compared to 8,000 deaths in 2013 (Jones & Treiber, 2010). In this study, the researchers wanted to determine how the understanding of how nursing experience were able to use Heideggerian method to identify how newly graduate nurses handled medication errors. The researcher was able to interview 20 new graduate nurses in Australia.  The data stated that three key concepts. These incorporated medication errors involving the five right contexts of medication management and over-dependence on medication management systems such as medication management computer reports and sheets. The five right of medication safety states that the right of a patient, right route, right drug, right time, and the right dosage. The findings from the study show that new graduate nurses viewed the system as dependable and a break from the heavily attributed duty of systematic checking against medication errors while in practice.  It is worth to understand that an analysis of the medication errors can assist healthcare professionals to make advancements reduce or prevent errors of taking effect (Bahrani et al.,  2011).

2.2 Medication Administration

Nurses play a vital role in administration of, knowledge or education about and evaluation of the efficiency and effectiveness of prescribing medication. The role of nurse’s changes with the setting of the patient. At home or in a community setting commonly noted as primary care, patients take their medication as prescribed by a medical practitioner.  They are also responsible for education the patient on about the possible side effects of his/her medication and evaluating the impacts of the prescribed therapy in maintaining and restoring patient health (Bahrani et al., 2011). These roles come with medication errors hence the need to contemplate on the most-possible solution to reduce effects that come with this medication hitch.

2.3 Type of medication errors


Types Causal factors Causes
Extra dose Job distraction Performance problems
Inappropriate dosage Increase of workload Procedure not followed
Omission error Inexperienced nurse Knowledge issues deficiency
Prescribing error Change of shift work Poor documentation
Technique Limited Staff Computer problems such as date entry
Wrong administration Limited pharmacy time Omitted transcription
Wrong time Data and information  
Preparation of wrong drug Cross coverage Poor system safeguard
Wrong route Limited access to patients  
Wrong patient Problem with code situation Unclear handwriting

Chapter 3

3.1 Research methodology

             In order to get the correct and accurate results the study employed quantitative research methodology because of various reasons such as, his use of the methodology is in its usefulness in generating reliable and factual results or outcome of data. After the effects of the medication errors have been evaluated or tested on a sample population, the statics will be recorded.  The methodology will offer objective results that will be generalized to the larger population. The statistical method related with quantitative research used in this study is well-suited for figuring out ways to maximize variable based on both dependent and independent variables. This will translate into a capacity for applying and identifying the intervention that will maximize the quantity and quality of life for the patient.  This chosen methodology is known to offer such information hence it reliability for the study.

            In addition, the method is used to avoid most-frequent problems that are related to reductionism; this offers me to take complex phenomenon ad to reduce them to limited numbers thereby reducing a nuance of the process.      The methodology will be helping reduce health cases to their essentials, very good of the finding will be used in the consideration for a given study.  Larger statistically representative sample that will be unfeasible in the study will be usefully analyzed using quantitative methodology. The other advantage of using the methodology is that It offers reliable understanding of a given research topic since the information will be analyzed with ease to assist future researchers to improve on the same.

3.2 Research Design

            The study will use a quantitative non-experimental correlation design to examine the relationship between the yeas of nursing experience and medication error among new nursing graduates.  A survey consisting of ten questions regarding medication management or administ.............

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