NURS-FPX4030 Assessment 2: Evidence-Based Practice and Quality Improvement

NURS-FPX4030: Improving Quality of Care and Patient Safety

Assessment 2: Evidence-Based Practice and Quality Improvement

Assessment Overview

This assessment requires you to analyze a clinical practice problem and synthesize evidence from scholarly literature to support a potential practice change. You will formulate a clinical question using the PICOT format, conduct a literature search, and analyze the findings to determine the best available evidence. This assessment measures your competency in using evidence-based practice models to investigate clinical problems and identify effective solutions, which is the foundational step before proposing a quality improvement initiative.

Assessment Instructions

Greetings Learners,

In this assessment, you will delve into the initial stages of the quality improvement process: identifying a problem and finding the evidence to solve it. Your task is to prepare an evidence-based practice brief that analyzes the clinical issue from the provided scenario and recommends a course of action based on a review of current literature. This brief will serve as the evidentiary foundation for the formal QI proposal you will develop in Assessment 3.

Review the same scenario from our course and complete the tasks that follow. Your paper should be 4-6 pages in length (excluding title and reference pages) and adhere to APA 7th edition formatting guidelines.

Scenario

You are a lead Registered Nurse on a busy 35-bed medical-surgical unit at Villa Health, a community hospital. Over the past six months, internal audits have revealed a 15% increase in medication administration errors. A preliminary analysis shows that the majority of these errors are related to incorrect dosage and administering medication to the wrong patient. These incidents have not yet resulted in serious patient harm, but the trend is alarming leadership. The hospital currently uses an Electronic Health Record (EHR) but has not yet implemented a barcode medication administration (BCMA) system. The nursing staff is experienced but reports high patient-to-nurse ratios and frequent interruptions during medication passes.

Assessment Tasks

Your evidence-based practice brief must address the following points in a clear, structured narrative:

1. Problem Description and PICOT Question:
   • Briefly describe the clinical problem and its impact on patient safety within the context of the scenario.
   • Formulate a precise, answerable clinical question in the PICOT format (Patient/Population, Intervention, Comparison, Outcome, Time) that addresses the central issue of medication errors.
2. Literature Search Strategy:
   • Describe the process you used to search for relevant literature.
   • Name at least two scholarly databases you used (e.g., CINAHL, PubMed, Cochrane Library).
   • List the primary keywords and search terms used to find articles related to your PICOT question.
3. Synthesis and Analysis of Evidence:
   • Identify and summarize three to four peer-reviewed articles published within the last five years that address your PICOT question.
   • For each article, briefly describe its findings and conclusions.
   • Synthesize the evidence. What are the common themes across the articles? Does the evidence collectively support a specific intervention to reduce medication errors? Critically analyze the strength of the evidence presented.
4. Evidence-Based Practice Recommendation:
   • Based on your synthesis of the literature, recommend a specific evidence-based practice change to address the medication error rates.
   • Justify your recommendation by explaining how the evidence you gathered supports this change as an effective solution for the problem outlined in the scenario.

References APA 7th Edition style.

1. Al-Jumaili, A. A., & Al-Rekabi, M. D. (2021). Effect of barcode medication administration system on the reduction of medication administration errors. International Journal of Nursing Sciences, 8(3), 326–332. https://doi.org/10.1016/j.ijnss.2021.05.006
2. Eriksen, K., & Mikkelsen, A. (2022). Nurses’ perceptions of the impact of barcode medication administration on patient safety: A qualitative study. Journal of Nursing Management, 30(7), 2969–2977. https://doi.org/10.1111/jonm.13735
3. Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.