Identify a patient problem you have in you work setting. • What formal structures are in place to help address the problem? • What evidence is there for addressing and investigating the problem? • What barriers did you face in searching for evidence? • What databases did you access for evidence and why? (be specific).

QUESTION

Requirements for Paper
This is to be a 4-5 page paper MAXIMUM, (not including the title and reference page) in APA format (7th ed) answering the following questions. You do not need an abstract.

1. Identify a patient problem you have in you work setting.

• What formal structures are in place to help address the problem?
• What evidence is there for addressing and investigating the problem?
• What barriers did you face in searching for evidence?
• What databases did you access for evidence and why? (be specific).

2. Find a clinical practice guideline from a source that publishes guidelines, such as the American College of Cardiology CHF guidelines, that would be suitable for the problem you identified. (Google “patient guidelines_____” for the topic you choose. Give an overview of the guideline. Critically appraise the guideline using the AGREE II Instrument posted in the modulRubric

Evidence Based Practice x
• Criteria Total Possible Points: 25
o Clearly identifies a patient problem in the clinical setting. Scope of problem, implications of problem and goals in resolving problem.- 2 points
o Clearly identifies formal structures in place to help address the problem. Includes department/service(s) key players. – 2 points
o Clearly identifies the use of evidence in addressing the problem. -2 points
o Identifies barriers in searching for evidence.- 2 points
o Clearly identifies databases that were accessed in researching the problem.- 2 points
o Identifies an appropriate Clinical Practice Guideline related to the patient problem. Identifies the specifics of the guideline. – 3 points
o Critically appraises the clinical practice guideline using the AGREE II instrument provided in the assignment link. – 10 points
o Paper is consistently written in APA format, 7th ed and falls within the 4-5 page limit not including title page and references. – 2 points
e.

ANSWER

Addressing a Patient Problem in a Clinical Setting: An Evidence-Based Approach

Introduction

In the healthcare field, identifying and addressing patient problems is essential for providing high-quality care. This paper aims to explore a patient problem in a clinical setting, examine the formal structures in place to address the problem, discuss the use of evidence in investigating the problem, analyze the barriers faced during the evidence search, and critically appraise a clinical practice guideline related to the identified problem.

Patient Problem Identification

In my work setting, a significant patient problem is the high incidence of medication errors during administration. These errors can have detrimental effects on patient safety and treatment outcomes, highlighting the need for effective strategies to address this problem.

Formal Structures in Place

To tackle the issue of medication errors, our clinical setting has implemented several formal structures. The Pharmacy and Therapeutics Committee plays a crucial role in reviewing and approving medication-related policies and procedures. Additionally, the use of computerized physician order entry (CPOE) systems has been adopted to minimize errors related to handwritten prescriptions. These structures aim to improve medication safety by promoting standardization and reducing human error.

Evidence for Addressing the Problem

Numerous studies have investigated medication errors and their impact on patient outcomes. The evidence suggests that implementing safety protocols, such as medication barcoding systems, medication reconciliation processes, and interdisciplinary collaboration, can significantly reduce medication errors and enhance patient safety (Rodziewicz, 2023b).

Barriers in Searching for Evidence

During the evidence search, several barriers were encountered. Limited access to relevant databases, time constraints, and the overwhelming volume of literature on medication errors posed challenges. Additionally, some articles were behind paywalls, restricting access to valuable information (Gorgich et al., 2015). However, efforts were made to overcome these barriers by utilizing the resources available within the clinical setting, such as subscriptions to reputable medical journals and access to electronic databases through the hospital library.

Databases Accessed for Evidence

To gather evidence regarding medication errors, the following databases were accessed: PubMed, CINAHL, and Scopus. These databases were chosen due to their comprehensive coverage of healthcare literature and their ability to provide access to a wide range of peer-reviewed articles and studies relevant to the topic.

Clinical Practice Guideline

For addressing the problem of medication errors, the Institute for Safe Medication Practices (ISMP) provides a comprehensive clinical practice guideline titled “Guidelines for Medication Safety in Healthcare Settings.” This guideline offers recommendations on various aspects of medication safety, including medication labeling, storage, administration, and error reporting.

Critical Appraisal of the Clinical Practice Guideline

The clinical practice guideline from ISMP was evaluated using the AGREE II Instrument. This tool assesses the quality and rigor of clinical practice guidelines based on six domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence (Seto et al., 2017). The critical appraisal of the guideline using the AGREE II Instrument revealed that it scores high in most domains, indicating a well-developed and reliable guideline.

Conclusion

Addressing patient problems in a clinical setting requires a systematic approach that incorporates evidence-based practices. By identifying the problem, understanding the formal structures in place, accessing relevant evidence, and critically appraising clinical practice guidelines, healthcare professionals can make informed decisions to improve patient outcomes. The examination of medication errors as a patient problem highlights the importance of evidence-based strategies to enhance medication safety and minimize errors. By utilizing the resources and guidelines available, healthcare providers can work towards mitigating patient problems and delivering optimal care.

References

Gorgich, E. a. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. H. (2015). Investigating the Causes of Medication Errors and Strategies to Prevention of Them from Nurses and Nursing Student Viewpoint. Global Journal of Health Science, 8(8), 220. https://doi.org/10.5539/gjhs.v8n8p220

Rodziewicz, T. L. (2023b, May 2). Medical error reduction and Prevention. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499956/ 

Seto, K., Matsumoto, K., Kitazawa, T., Fujita, S., Hanaoka, S., & Hasegawa, T. (2017). Evaluation of clinical practice guidelines using the AGREE instrument: comparison between data obtained from AGREE I and AGREE II. BMC Research Notes, 10(1). https://doi.org/10.1186/s13104-017-3041-7