Evidence-Based Project: Advanced Levels of Clinical Inquiry and Systematic Reviews

The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 7- to 8-slide PowerPoint presentation in which you do the following:

CriteriaRatingsPtsPart 2: Advanced Levels of ClinicalInquiry and Systematic Reviews Create a 7- to 8-slide PowerPoint presentationin which you do the following: · Identify and briefly describe your chosenclinical issue of interest. · Describe how you developed a PICO(T) questionfocused on your chosen clinical issue of interest. · Identify the four researchdatabases that you used to conduct your search for the peer-reviewed articlesyou selected. · Describe the levels of evidence in each of the fourpeer-reviewed articles you selected, including an explanation of thestrengths of using systematic reviews for clinical research. Be specific andprovide examples.80 to >71.0 ptsExcellentThe presentation clearly and accurately identifies anddescribes in detail the chosen clinical issue of interest. …Thepresentation clearly and accurately describes in detail the developedPICO(T) question. …The presentation clearly and accurately identifiesfour or more research databases used to conduct a search for thepeer-reviewed articles selected. …The presentation includes specific andrelevant examples that fully support the research. …The presentationprovides a complete, detailed, and accurate synthesis of two outsideresources related to the peer-reviewed articles selected, and fullyintegrates at least two outside resources and two or three course-specificresources that fully support the presentation.71 to >63.0 ptsGoodThe presentation accurately identifies and describes thechosen clinical issue of interest. …The presentation accurately describesthe developed PICO(T) question focused on the chosen clinical issue ofinterest. …The presentation accurately identifies at least four researchdatabases used to conduct a search for the peer-reviewed articles selected….The presentation includes relevant examples that support the researchpresented.63 to >55.0 ptsFairThe presentation inaccurately or vaguely identifies anddescribes the chosen clinical issue of interest. …The presentationinaccurately or vaguely describes the developed PICO(T) question focused onthe chosen clinical issue of interest. …The presentation inaccurately orvaguely identifies at least four research databases used to conduct asearch for the peer-reviewed articles selected. …The presentationincludes inaccurate or vague examples to support the research presented.55 to >0 ptsPoorThe presentation inaccurately and vaguely identifies anddescribes the chosen clinical issue of interest or is missing. …Thepresentation inaccurately and vaguely describes the developed PICO(T)question or is missing. …The presentation inaccurately and vaguelyidentifies less than four research databases used to conduct a search forthe peer-reviewed articles selected or is missing. …The presentationincludes inaccurate and vague examples to support the research presented oris missing.80 ptsResource Synthesis5 to >4.0 ptsExcellentUsing proper in-text citations, the presentation clearlyand accurately provides at least four peer-reviewed systematic review typearticles selected, describes the levels of evidence in each of the fourarticles selected, including a thorough and detailed explanation of thestrengths of using systematic reviews for clinical research.4 to >3.0 ptsGoodUsing proper in-text citations, the presentationaccurately provides at least four systematic review type peer-reviewedarticles selected including adequate explanation of the levels of evidence,the strengths of using a systematic review for3 to >2.0 ptsFairUsing proper in-text citations, the presentationprovides a vague or inaccurate synthesis or outside resources related tothe systematic review type peer-reviewed articles selected. The responseminimally explains the levels of evidence and the strengths of using asystematic review and/or minimally integrates resources that may supportthe presentation.2 to >0 ptsPoorThe presentation provides a vague and inaccuratesynthesis of no outside resources related to the articles selected andfails to integrate any resources to support the presentation or is missing.5 ptsResource Formatting Appropriatepeer-reviewed articles are included and citations use APA format.5 to >4.0 ptsExcellentPresentation includes 4 or more peer-reviewed articlesselected using systematic reviews for clinical research. …Citations usecorrect APA format with no errors.4 to >3.0 ptsGoodPresentation includes 3 peer-reviewed articles selectedusing systematic reviews for clinical research. …Citations use correctAPA format with few (1-2) errors.3 to >2.0 ptsFairPresentation includes 2 peer-reviewed articles selectedusing systematic reviews for clinical research. …Citations containseveral (3-4) APA format errors.2 to >0 ptsPoorPresentation includes 1 or no resources. … Citationscontain many >5 APA format errors.5 ptsPowerPoint Presentation: Thepresentation is professional; images are appropriately attributed; images areclear. The presentation text is readable. Presentation flows well and ispresented in a logical order.5 to >4.0 ptsExcellentThe presentation is professional; images areappropriately attributed; images are clear. The presentation text isreadable. Presentation flows well and is presented in a logical order.4 to >3.0 ptsGoodEighty percent of the presentation is professional;images are appropriately attributed; images are clear. The presentationtext is readable. Presentation flows well and is presented in a logicalorder.3 to >2.0 ptsFairSixty to seventy nine percent of the presentationfollows these guidelines: presentation is professional; images areappropriately attributed; images are clear. The presentation text isreadable. Presentation flows well and is presented in a logical order.2 to >0 ptsPoorLess than sixty percent of the presentation followsthese guidelines: presentation is professional; images are appropriatelyattributed; images are clear. The presentation text is readable.Presentation flows well and is presented in a logical order.5 ptsWritten Expression andFormatting—English Writing Standards: Correct grammar, mechanics, and properpunctuation.5 to >4.0 ptsExcellentUses correct grammar, spelling, and punctuation with noerrors.4 to >3.0 ptsGoodContains a few (one or two) grammar, spelling, andpunctuation errors.3 to >2.0 ptsFairContains several (three or four) grammar, spelling, andpunctuation errors.2 to >0 ptsPoorContains many (five or more) grammar, spelling, andpunctuation errors that interfere with the reader’s understanding.5 ptsTotalPoints: 100 Matrix Worksheet
Template
Matrix Worksheet Template
Use this document to complete Part 1 of the Module 2 Assessment, Evidence-Based Project, Part 1: Identifying Research
Methodologies
Full citation of
selected article
Article #1
Alomari, A.,
Sheppard‐Law, S.,
Lewis, J., & Wilson, V.
(2020). Effectiveness of
clinical nurses’
interventions in
reducing medication
errors in a paediatric
ward. Journal of
Clinical Nursing, 29(1718), 3403-3413.
https://doi.org/10.1111/j
ocn.15374
Article #2
Berdot, S., Vilfaillot, A.,
Bezie, Y., Perrin, G.,
Berge, M., Corny, J., &
Sabatier, B. (2021).
Effectiveness of a ‘do
not interrupt’ vest
intervention to reduce
medication errors
during medication
administration: A
multicenter cluster
randomized controlled
trial. BMC Nursing,
20(1), 153.
https://doi.org/10.1186/
s12912-021-00671-7
© 2021 Walden University, LLC
Article #3
Manias, E., Cranswick,
N., Newall, F.,
Rosenfeld, E., Weiner,
C., Williams, A., &
Kinney, S. (2019).
Medication error trends
and effects of
person‐related,
environment‐related
and
communication‐related
factors on medication
errors in a paediatric
hospital. Journal of
Paediatrics and Child
Health, 55(3), 320-326.
https://doi.org/10.1111/j
pc.14193
Article #4
Westbrook, J. I., Li, L.,
Raban, M. Z., Woods,
A., Koyama, A. K.,
Baysari, M. T., & White,
L. (2021). Associations
between doublechecking and
medication
administration errors: a
direct observational
study of paediatric
inpatients. BMJ Quality
& Safety, 30(4), 320330.
https://doi.org/10.1136/
bmjqs-2020-011473
1
Why you chose this
article and/or how it
relates to the clinical
issue of interest
(include a brief
explanation of the
ethics of research
related to your clinical
issue of interest)
This article was
selected because it reports
the findings of action
research study on
interventions to reduce
medication errors. The
article is a peer-reviewed
journal article on various
interventions for medication
errors. It relates to the
clinical issue of interest
because it focuses on
means to address errors.
The study observes the
ethical consideration of
autonomy and informed
consent. This relates to the
research participants’ right
to withdraw from the study
at any moment.
This article was
selected for its contribution
to the research on solutions
to reduce medication errors.
It is a randomized controlled
trial on medication error
interventions to reduce
interruptions during
medication administration.
The article provides
evidence regarding the use
of ‘do not interrupt’ vests in
medications administration.
A potential ethical issue in
this study is the
confidentiality of patients’
information and data. All
data in the study was
processed anonymously
and participants’ identity
was protected.
The rationale for
selecting this study is its
reporting on factors
associated with medication
errors. It was selected
because it outlines
important factors to consider
in order to reduce errors. It
relates to the issue of
concern by outlining factors
leading to the problem of
medication errors. As a
retrospective evaluation, the
article has few ethical
concerns. However, it is still
necessary to ensure
informed consent is
obtained from the
participants. This study
presents no need for
informed consent.
Brief description of
the aims of the
research of each
peer-reviewed article
The aim of the study
was to test the effectiveness
of a bundle of interventions
to reduce medication errors.
The researchers’ aim was to
develop and implement
medication error reduction
interventions. This research
served to test the
effectiveness of the
methods and implemented
interventions. These
included mobile medication
The aim of the research
was to evaluate whether
wearing a ‘do not interrupt’
vest reduced medication
administration errors. The
‘do not interrupt’ vest is an
intervention whereby nurses
can reduce interruptions
from the environment when
administering medications.
The aim for the study was to
determine whether the vest
appropriately reduced
This study aimed to
retrospectively evaluate the
number of errors reported in
a hospital. The setting was
an Australian pediatric
hospital. The researchers
aimed to determine the
rates of errors in a five-year
period and also identify
person-, environment-, and
communication-related
factors affecting severity of
errors. The study sought to
© 2021 Walden University, LLC
This study was selected
for the project because of its
focus on medication
administration errors. It
contributes to the current
project by identifying a
potential intervention to
reduce errors. The topic of
medication errors is
associated with patient
harm and this article was
selected due to its potential
to reduce errors and hence
harm to the patients. The
study recruited pediatric
patients, a vulnerable
population. It is essential to
consider the rights of the
children and potential
impact of research on their
well-being. This study
presented no foreseeable
harm but also included
ethics approval.
The purpose of the
study was to improve
medications safety by
reviewing effectiveness of
an intervention. The
intervention was doublechecking, a process for
nurses to separately check
information and then share
it. The researchers identified
the lack of quantification of
double-checking in
preventing medication
2
administration trolleys,
parental involvement,
monthly safety and quality
meetings, change in
medication administration
hours, and policy revision.
Brief description of
the research
methodology used
Be sure to identify if
the methodology used
was qualitative,
quantitative, or a
mixed-methods
approach. Be specific.
The methodology used
was action-research using a
quantitative research
approach. Quantitative
research involves statistical
data and hypothesis testing
(Hoare & Hoe, 2013). In this
study, for instance, the main
outcome is the rates of
medication errors reported
as errors per 1,000
prescribed medications. The
researchers evaluated the
rates of errors before and
after the interventions,
essentially a pre- and posttest quantitative approach.
interruptions and
consequently led to safer
medication administration.
This study focuses on a
potential solution to reduce
medication administration
errors in the ward.
The study was
conducted using a
quantitative methodology.
Specifically, it is defined as
a multicenter cluster
randomized controlled trial.
In this methodology, the
study was conducted by
randomly selecting hospitals
to participate in the study. A
comparison of pre- and
post-intervention rates of
errors in the intervention
and control groups was
conducted. Data was
analyzed using descriptive
statistics approach.
A brief description of
the strengths of each
of the research
methodologies used,
including reliability
and validity of how
the methodology was
The main strength of the
research methodology used
in this article is the inclusion
of employees and the valid
evaluation of the pre- and
post-intervention outcomes.
Action-research is
This study is reliable
and valid and preferred due
to the methodology. The
preference for randomized
controlled trial reduces bias
and enhances attribution of
outcomes to the
© 2021 Walden University, LLC
establish the frequency and
severity of errors including
factors that affected the
latter.
errors. The study, therefore,
sought to fill that gap and
determine whether doublechecking was associated
with reduction of frequency
and severity of errors.
The research
methodology was a
quantitative retrospective
audit of the hospital. The
audit was performed
through a collection of
quantitative statistical data
on medication errors.
Medication errors were
reported as errors per 1000
bed days. Data was
analyzed statistically using
SPSS with univariate
associations and multiple
logistic regression analysis.
The study is a
quantitative methodology
approach for analyzing
errors through observation.
Among participants, a
trained observer was
recruited to examine their
process for medications
preparation and
administration including
identifying any errors.
Medication administration
errors were also rated for
severity. Researchers then
compared errors before and
after intervention using
statistical data analysis.
This study has a good
quality of research and
methodology used for the
research process. The
researchers used a
retrospective study
approach. The advantage of
The direct observation of
staff presents a strength as
well as a weakness. On the
one hand, it promotes less
biased reporting and data
analysis to ensure a valid
and reliable process.
3
applied in each of the
peer-reviewed articles
you selected.
advantageous in that the
staff are involved in making
permanent changes
(Banegas & de Castro,
2019). It can be classified
as a form of quality
improvement with a
research aspect. The main
tool used to measure
outcomes apart from rates
of errors was the Safety
Attitudes Questionnaire
(SAQ), a validated tool. The
reliability of the tool is high
with Cronbach alpha of 0.9
and validity acceptable. The
research methodology was
rigorous and hence the
article presents a valid and
reliable resource to consult
in the clinical issue
research.
interventions (Hoare & Hoe,
2013). Moreover, the study
was conducted in several
hospitals, increasing its
reliability and
generalizability. Reliability is
the confidence that the
outcomes can be replicated
and validity is the
confidence that the study
measures what it purports to
measure (Hoe & Hoare,
2012). It is reliable due to
the inclusion of several
hospitals. It is valid because
trained observers have
been deployed in the study.
this methodology is that
there is little risk of bias as
the evaluated events have
already occurred. Therefore,
a retrospective audit and
data analysis presents a
more objective and less
biased approach. The study
is valid since specific
records for medication
errors with voluntary
reporting were maintained
and used in this study.
Similarly, it is reliable
because the reporting
system and measures
remained constant
throughout the data
collection period.
Observers were rigorously
trained. On the other hand,
observation may increase
compliance with policy due
to the presence of the
observer in the participant’s
environment (Fix et al.,
2022). The Precise
Observation System for the
Safe Use of Medicines
(POSSUM) was the tool
used and its reliability is
high, about 0.83 alpha level.
It has also acceptable
validity. Overall, the article
presents an important
contribution in the
evaluation of doublechecking interventions.
General
Notes/Comments
© 2021 Walden University, LLC
4
References
Alomari, A., Sheppard‐Law, S., Lewis, J., & Wilson, V. (2020). Effectiveness of clinical nurses’ interventions in reducing medication
errors in a paediatric ward. Journal of Clinical Nursing, 29(17-18), 3403-3413. https://doi.org/10.1111/jocn.15374
Banegas, D. L., & de Castro, L. S. V. (2019). Action research. In The Routledge handbook of English language teacher education (pp.
570-582). Routledge.
Berdot, S., Vilfaillot, A., Bezie, Y., Perrin, G., Berge, M., Corny, J., & Sabatier, B. (2021). Effectiveness of a ‘do not interrupt’ vest
intervention to reduce medication errors during medication administration: A multicenter cluster randomized controlled trial.
BMC Nursing, 20(1), 153. https://doi.org/10.1186/s12912-021-00671-7
Fix, G. M., Kim, B., Ruben, M. A., & McCullough, M. B. (2022). Direct observation methods: A practical guide for health
researchers. PEC Innovation, 1, 100036. https://doi.org/10.1016/j.pecinn.2022.100036
Hoare, Z., & Hoe, J. (2013). Understanding quantitative research: Part 2. Nursing Standard, 27(18), 48–55.
https://doi.org/10.7748/ns2013.01.27.18.48.c9488
Hoe, J., & Hoare, Z. (2012). Understanding quantitative research: Part 1. Nursing Standards 27(15), 52–57.
https://doi.org/10.7748/ns2012.12.27.15.52.c9485
Manias, E., Cranswick, N., Newall, F., Rosenfeld, E., Weiner, C., Williams, A., & Kinney, S. (2019). Medication error trends and
effects of person‐related, environment‐related and communication‐related factors on medication errors in a paediatric hospital.
Journal of Paediatrics and Child Health, 55(3), 320-326. https://doi.org/10.1111/jpc.14193
Westbrook, J. I., Li, L., Raban, M. Z., Woods, A., Koyama, A. K., Baysari, M. T., & White, L. (2021). Associations between doublechecking and medication administration errors: a direct observational study of paediatric inpatients. BMJ Quality & Safety,
30(4), 320-330. https://doi.org/10.1136/bmjqs-2020-011473
© 2021 Walden University, LLC
5
1
Database Search
Name
Institution
Course
Professor
Date
2
Database Search
The clinical issue of interested considered in this database search was medication errors
in the hospital. The rationale for considering this issue is that medication errors are a major cause
of preventable harm in the hospital setting. There are approximately 100,000 reports of suspected
medication errors reported to the Food and Drug Administration (FDA) each year (FDA, 2019).
Errors are a major cause of injury and adversely affect health safety and quality of care provided
to patients. Therefore, they must be addressed to promote high quality and safe care.
Interventions to reduce medication errors can be studied in current research.
The two databases included in this search were PubMed and Google Scholar. The search
was conducted based on the preliminary PICOT question: In an in-patient primary care setting
(P) does barcode medication administration (I) compared to no barcode (C) reduce the rates of
medication errors (O) in three months (T)? The proposed intervention, according to this PICOT,
is barcode medication administration. The keywords used in the search are: “medication errors”
and “barcode medication administration.”
The initial search produced 91 articles on PubMed after limiting the search to articles
published between 2000 and 2023 and free full-text available. However, after applying filters to
only include primary research, this narrowed to only 16 articles. Further, after limiting to the last
five years, only five articles met the criteria. Using the two keywords and changing the Boolean
phrase from AND to OR, the search was expanded to 528 results. From this search, it occurs that
the Boolean phrase and specific restrictions can expand or restrict the search results. The search
on Google Scholar presented the same patterns with more than 100 articles without restrictions
and less than 10 after all restrictions were applied.
3
An effective way to increase the rigor of database search is to use several databases as
well as cross-referencing. Multiple database search can help produce the maximum number of
articles on the topic. For instance, an article could be on CONAHL but not on PubMed.
Moreover, cross-referencing is an important approach whereby using one article can help find
other articles in a snowballing approach (Morin et al., 2021). For instance, studies used in a
systematic review can be accessed as primary research. This can expand the number of articles
and help access high quality research.
4
References
Morin, J. É., Olsson, C., & Atikcan, E. Ö. (Eds.). (2021). Research methods in the social
sciences: An AZ of key concepts. Oxford University Press, USA.
US Food and Drug Administration. (2019, Aug. 23). Working to Reduce Medication Errors.
https://www.fda.gov/drugs/information-consumers-and-patients-drugs/working-reducemedication-errors