The PICO(T) process is used in clinical settings to support evidence-based practice. It involves considering various factors, such as the population affected by a problem, the interventions that could potentially solve it, the comparison of those interventions to other options, the outcome of the research, and the amount of time necessary to provide the best care. This framework is helpful for various purposes, including creating research questions, developing nursing care plans, and evaluating the effectiveness of evidence-based therapies (Lira & Rocha, 2019). The PICO(T) process searches for evidence in academic literature and online sources to support the results and provide context for the research topic.
The PICO(T) Framework for Medication Errors
Medication errors persist as a concern in healthcare facilities such as hospitals and emergency centers, where it is estimated that each patient experiences at least one medication error per day (Ma et al., 2021). These mistakes can result in severe consequences, both professionally and personally, and cost the healthcare industry millions of dollars each year and lives (Ma et al., 2021). The PICOT framework helps researchers identify and approach the issue of medication errors and find practical solutions, leading to improved patient safety. The research focuses on the positive impact of enhancing communication and following the “five rights” in acute care settings and compares it to other techniques in reducing medication errors for a year (World Health Organization, 2019). The central research question asks: “What is the favorable effect of enhancing communication and the “five rights” in acute care compared to alternative techniques in reducing medication errors over a year?” The PICOT approach breaks down the question for better research and outcomes for quality improvement (World Health Organization, 2019).
The PICOT framework focuses on the people or group impacted by the issue being studied, in this case, medication errors. The first step is to answer and elaborate on the “P” question about the population affected by the issue. Research-based on evidence-based practice (EBP) is necessary at this stage (World Health Organization, 2019). The “C” stage involves comparing the approaches to find the best solution to the issue, which involves analyzing a controlled group using the “five rights” method and effective communication through skill development, with a focus on enhancing computer literacy (World Health Organization, 2019). The “O” stage focuses on the outcome of the strategy or model and the research findings in clinical practice settings. The framework aims to determine the most effective technique for reducing medication errors in healthcare settings and requires a yearly review to monitor progress and determine if any revisions or improvements are needed.
Identification of Evidence Sources
The sources of evidence that are effective in addressing medication errors include a combination of well-designed clinical studies, analysis of medical records, reports of errors, and evaluations of nurse competencies. Clinical studies provide insight into actions that may cause medication errors and their impact, as seen in EBP-controlled observations. Reviewing medical records provides evidence of errors that lead to adverse outcomes (Trakulsunti et al., 2021). Incident reports are valuable in helping practitioners make necessary adjustments and prevent future incidents by uncovering the root causes. Assessing nurse abilities is also crucial in understanding the factors contributing to medication errors. The evidence-based findings support the benefits of change and the effectiveness of teaching methods and simulations in reducing medication errors (Trakulsunti et al., 2021). Reliable resources to address the PICOT questions can be found in peer-reviewed scientific journals, which offer critically evaluated data, evidence, modeling techniques, controlled research, past experiences, and interviews.
Explaining Findings from Articles
Studies have found that there are over one million medication error episodes (MEE) each year, nearly 100% being preventable. In the United States, medical error events are one of the leading causes of death, responsible for over 200,000 fatalities annually. This issue is not just limited to acute care settings but extends to other care environments, impacting the future quality of care (Blazin et al., 2020). The causes of adverse events include factors such as practitioner distraction, heavy workloads, and lack of skills and knowledge. The systematic review provides evidence-based models, strategies, and suggestions to address the PICOT question and improve the quality of care. Pre-testing the attitudes and abilities of care nurses is crucial for enhancing patient safety and ensuring the success of any implemented changes and solutions (Blazin et al., 2020). Research has shown that reducing the number of interruptions during medication administration can decrease adverse events. The role of practitioners in reducing medication errors is also highlighted as crucial, as they play a significant part in interacting with others and the environment.
Medication errors are a significant issue, and Van Ewijk’s (2018) research highlights their connection to interruptions and distractions in healthcare settings. The article emphasizes the importance of using evidence-based methods and practices to minimize medication errors for various patient groups. The PDSA cycle and its supportive evidence are mentioned as a technique to tackle the problem of medication errors by reducing interruptions and distractions (England, 2021). The PDSA cycle is a quality improvement method that focuses on improving the performance of healthcare providers by constantly revising processes, routines, and strategies that result in adverse outcomes. It involves planning, implementing changes, observing the impact, and making further improvements (England, 2021). The article also emphasizes the need for a supportive clinical care environment for healthcare providers to deliver quality care. This involves reducing distractions, minimizing staff interactions, and creating an environment that promotes effective practices. In practice, distractions impact healthcare providers’ work, increase patient safety risks, and shift focus toward optimizing outcomes.
The research by Ibrahim et al. (2020) highlights the significance of using evidence-based practices to gather data and obtain favorable outcomes. The study also highlights the potential for adverse events, such as medication errors, to occur in clinical settings, particularly during high-pressure situations. The research delves into two key concerns, which are whether implementing measures to decrease medication errors would lower the frequency of adverse events and if the new strategy would reduce medical administration incidents. The research assesses various behaviors, techniques, and metrics that provide insight into the crucial concerns, including the proposal to improve hourly rounds, reduce interruptions, and enhance practitioner training (Ibrahim et al., 2020). The pilot assessment of the results showed the importance of making changes in clinical practices and incorporating evidence-based practices to reduce medication errors.
Relevance of Findings from Article
The choice of using a particular scientific publication in a study depends on the relevance of the article’s topic. The peer-reviewed research by Sittig et al. (2020) focuses on the potential of barcode technology to prevent medical errors and meets all four criteria (importance, reliability, authority, and scope) set by the CRAAP research from 2014 (Sittig et al., 2020). The significance of barcode scanning in enhancing hospital accuracy is emphasized in the study, with a recommendation to use credible sources like PubMed, the Cochrane Library, and Embase. The study emphasizes the importance of wristband barcode scanning in reducing medication errors and is free of any conflicts of interest in its dissemination, aimed at promoting better knowledge.
Conclusion
In conclusion, the PICO(T) process is an essential tool for healthcare practitioners to support evidence-based practice. The framework helps researchers approach complex issues, such as medication errors, by focusing on various aspects of the problem, such as population, intervention, comparison, outcome, and time. The PICOT framework is instrumental in addressing medication errors, which persist as a concern in healthcare facilities and can lead to severe consequences. The PICOT approach to medication errors is focused on enhancing communication and the “five rights” method in acute care, and it is compared to other techniques in reducing medication errors. The sources of evidence include clinical studies, medical record analysis, incident reports, and nurse competency evaluations. The results suggest that reducing interruptions and distractions and creating a supportive clinical care environment are crucial in improving patient safety and reducing medication errors. The PDSA cycle is another evidence-based technique used to tackle medication errors. The evidence-based practices used in the PICOT framework ensure that favorable outcomes are obtained and help to improve the quality of care in healthcare settings.
References
(World Health Organization, 2019). Medication safety in transitions of care: technical report (No. WHO/UHC/SDS/2019.9). World Health Organization. https://creativecommons.org/licenses/by-nc-sa/3.0/igo
Blazin, L. J., Sitthi-Amorn, J., Hoffman, J. M., & Burlison, J. D. (2020). Improving patient handoffs and transitions through adaptation and implementation of I-PASS across multiple handoff settings. Pediatric quality & safety, 5(4). 10.1097/pq9.0000000000000323
England, N. H. S. (2021). Plan, Do Study, Act (PDSA) cycles and the model for improvement. https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&as_ylo=2019&q=pdsa+cycle&btnG=
Lira, R. P. C., & Rocha, E. M. (2019). PICOT: Imprescriptible items in a clinical research question. Arquivos Brasileiros de Oftalmologia, 82, 1-1. https://doi.org/10.5935/0004-2749.20190028
Ma, L., Mu, Y., Wei, L., & Wang, X. (2021). Practical application of QR code electronic manuals in equipment management and training. Frontiers in Public Health, 9, 726063. https://doi.org/10.3389/fpubh.2021.726063
Sittig, D. F., Wright, A., Coiera, E., Magrabi, F., Ratwani, R., Bates, D. W., & Singh, H. (2020). Current challenges in health information technology–related patient safety. Health informatics journal, 26(1), 181-189. https://journals.sagepub.com/doi/pdf/10.1177/1460458218814893
Trakulsunti, Y., Antony, J., Dempsey, M., & Brennan, A. (2021). Reducing medication errors using lean six sigma methodology in a Thai hospital: an action research study. International Journal of Quality & Reliability Management, 38(1), 339-362. https://doi.org/10.1108/IJQRM-10-2019-0334
Van Ewijk, B. (2018). Medication Error Prevention: Improving Patient Health Outcome. Institutional Repository (IR) at the University of San Francisco (USF), hosted by Gleeson Library. https://repository.usfca.edu/cgi/viewcontent.cgi?article=2176&context=thes
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