In preparation for your assignment this week, brainstorm two to three clinical practice problems or issues you can develop into a nursing practice change. What indicates these as clinical issues in nursing practice? Support your discussion with two peer-reviewed journal articles.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format.
Discussion Post: Clinical Practice Problems in Nursing
In clinical practice, identifying areas for improvement is essential for advancing patient care, enhancing safety, and increasing nursing efficiency. After reflecting on common challenges in healthcare settings, three clinical practice problems stand out: (1) medication administration errors, (2) inadequate pain management, and (3) nurse burnout and staffing shortages.
1. Medication Administration Errors
Medication errors remain a persistent issue in clinical nursing practice. These can result from miscommunication, distractions, or lack of standardization in protocols. According to a study by Keers et al. (2018), medication administration errors are prevalent in hospitals and can lead to significant patient harm. The study emphasizes the need for systems-based interventions, such as bar-code medication administration (BCMA) and improved electronic health record (EHR) documentation, to reduce errors.
2. Inadequate Pain Management
Pain management is another pressing concern. Nurses often struggle to balance effective pain relief with concerns about overmedication, particularly in light of the opioid epidemic. Evidence suggests that pain is frequently under-assessed and under-treated, especially in vulnerable populations such as the elderly or non-verbal patients. A review by Booker et al. (2021) highlighted that education and implementation of multimodal pain management strategies improved outcomes and patient satisfaction.
3. Nurse Burnout and Staffing Shortages
Lastly, nurse burnout exacerbated by chronic understaffing poses a significant threat to both patient outcomes and nurse retention. Maslach burnout inventory assessments have shown high levels of emotional exhaustion among nurses, correlating with increased patient mortality and error rates. Dall’Ora et al. (2020) found that higher nurse-to-patient ratios were associated with lower burnout rates and better patient safety outcomes.
Each of these issues is supported by substantial evidence and presents opportunities for nursing practice change. Interventions such as implementing structured protocols, continuous education, and advocating for safer staffing ratios are essential to address these persistent challenges.
References:
Booker, S. Q., Herr, K., & Fine, P. G. (2021). Multimodal approaches to pain management: An integrative review. Pain Management Nursing, 22(3), 287-295. https://doi.org/10.1016/j.pmn.2020.10.008
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, 18(1), 41. https://doi.org/10.1186/s12960-020-00469-9
Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2018). Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence. Drug Safety, 36(11), 1045–1067. https://doi.org/10.1007/s40264-013-0090-2
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