“Developing Nurse Medication Safety Training” by Bull

Errors in the administration of medications remain a pervasive practice problem. Modern quantitative studies that explore the role of training programs for nurses in reducing medication mistakes can help to answer the previously identified PICOT question. This essay aims to critique two peer-reviewed quantitative studies, thus concluding on their uses in answering the PICOT question.


Bull et al. (2017) explore inaccuracies in drug administration in developing countries. The study is significant to nursing since it adds new knowledge regarding the development of drug administration workshops. Its purpose involves improving drug calculation skills in nurses in low-income economies. The objectives include exploring international health partnerships’ contributions to the creation of drug-dosage calculation learning opportunities and defining health psychologists’ role in supporting nurse educators’ attempts to implement behavioral research into training. The research question relates to international partnership workshops’ impact on nurses’ ability to calculate drugs.

The source by Pahlavanzadeh et al. (2016) is focused on the problem of workplace stress in ICU nurses and its harmful effects on care quality. This RCT is relevant to nursing since it concludes on the effectiveness of a nurse education program to teach stress management skills. Its purpose and objectives include promoting effective stress management education by studying the effects of a ten-session program on the quality of ICU nurses’ work. The research question is related to the effects of stress management on care quality determined by comparing care quality in the intervention and control groups.

Support of Nursing Practice

The study by Bull et al. (2017) can help to answer the PICOT question since the authors’ statistics demonstrate positive links between the implementation of drug-dosage calculation training and hospital nurses’ confidence in their dosage calculation skills. It can be suggested that nurses’ confidence and refreshed knowledge after training would reduce accidental medication dosage errors in the population discussed in the PICOT question. In the PICOT, the intervention and comparison groups are presented by ICU nurses that have and have not received training aimed at improving medication management skills. Bull et al. (2017) focus on measuring nurses’ confidence and skills after the workshop, which is why only the intervention group (nurses that have attended the medication safety workshop) is mentioned. Thus, intervention groups in the PICOT and the study share obvious similarities.

In their RCT, Pahlavanzadeh et al. (2016) demonstrate that nurse training focused on stress reduction increases the quality of nursing care at ICU, which has implications for patient outcomes. These results support the PICOT due to similarities between the selected problems (medication errors and care quality) and suggest that nurse training would be followed by better care quality, which might include fewer medication errors. The source does not emphasize health outcomes in post-surgery ICU patients, but it suggests that nurse training enables nurses to recognize and respond to the signs of job burnout, thus reducing the risks of mistakes resulting from exhaustion (Pahlavanzadeh et al., 2016). In the source and the PICOT, the intervention and comparison groups present ICU nurses that have/have not received training, so this source’s degree of applicability to the PICOT is very high.

Methods of Study

Bull et al. (2017) use quantitative drug calculation and confidence/intention questions included in their nurse education tool. Qualitative methods, such as semi-structured interviews and observations made during education sessions, are also mentioned (Bull et al., 2017). Differently from that, Pahlavanzadeh et al. (2016) mention one two-section (demographic/care quality questions) quantitative tool used as a post-intervention and follow-up questionnaire. Unlike the tools in Bull et al. (2017), this questionnaire includes questions from a standard quantitative tool approved for the measurement of nursing care quality (Pahlavanzadeh et al., 2016). The limitations of Bull et al.’s (2017) methods include a lack of nuanced answers for questionnaires (simplistic yes/no questions are common), time expenditures for semi-structured interviews, and the risks of experimenter bias for observations. The benefits include inexpensiveness for questionnaires and the ability to explore beliefs and behaviors for interviews and observations. Regarding the questionnaire method in Pahlavanzadeh et al. (2016), its benefit is the ability to quantify the results easily, which allows studying large samples, and the potential limitation is a lack of personal contact with participants to prevent the misinterpretation of questions/terms.



Bull et al. (2017) report two important effects of a training package aimed at improving hospital nurses’ medication calculation skills. Firstly, the participants’ self-reported confidence in medication calculation tasks was high even without the training, but it increased even more after the implementation of training sessions. Secondly, hospital nurses’ readiness to use calculators to check the correctness of their drug dose decisions increased after training sessions.

Pahlavanzadeh et al. (2016) also report the positive influences of their stress management training program on nursing care. According to the findings, nursing care quality scores in the intervention group were increased right after and four weeks after the intervention if compared to the pre-intervention scores and the scores in the comparison group. Increases in care quality scores after the training program were in all three dimensions of quality (communication, physical, psychosocial).


The findings reported by Bull et al. (2017) support the effectiveness of multidisciplinary health partnerships in nurse education projects. Moreover, based on the tested training program’s effects on nurses’ motivation to recheck their calculations, the program can be used in practice settings to increase nurses’ self-awareness in terms of dosage calculation skills. As for Pahlavanzadeh et al. (2016), their findings suggest that teaching stress management techniques to ICU nurses during seminars and continuing education sessions is a way for healthcare institutions to promote better care quality.

Outcomes Comparison

Concerning outcomes for the PICOT question, it is reasonable to expect that the use of training programs for ICU nurses that emphasize drug prescription/administration will improve these professionals’ pharmacological knowledge and medication administration skills. As a result, improved skills will be likely to lead to fewer medication errors and cases of readmission in post-surgery patients. To address ethical considerations, it will be critical to receive approval from local ethics committees and ensure participants’ anonymity.

Apart from obvious similarities in terms of interventions (nurse training), the reviewed sources and the planned study share general similarities in outcomes – the outcomes are or are expected to be positive and promote patient safety. Regarding differences, the study conducted using the selected PICOT question can be expected to lead to more objective outcomes due to the chosen measures of success. To measure outcomes and evaluate the effectiveness of their training programs, Bull et al. (2017) and Pahlavanzadeh et al. (2016) rely on information from self-assessments, which involves the risks of biases or even intentional distortions. For instance, the outcomes reported by Bull et al. (2017) include increases in participants’ confidence in their skills and intentions to use calculators, whereas Pahlavanzadeh et al. (2016) report positive changes in care quality from the viewpoint of care providers, not care recipients. In contrast, the study conducted using the PICOT question would make use of indicators based on objective and verifiable data (medication error and patient readmission rates).


In summary, despite the use of different outcome measures, the reviewed studies can be used to answer the previously selected PICOT question. It is because both sources demonstrate the positive effects of training programs for nurses. According to them, training supports the quality of nursing care and care providers’ motivation to recheck their decisions and calculations.


Bull, E. R., Mason, C., Domingos, F., Santos, L. V., Scott, A., Ademokun, D., Simiao, Z., Oliver, W. M., Joaquim, F. F., & Cavanagh, S. M. (2017). Developing nurse medication safety training in a health partnership in Mozambique using behavioral science. Globalization and Health, 13(1), 1-10. Web.

Pahlavanzadeh, S., Asgari, Z., & Alimohammadi, N. (2016). Effects of stress management program on the quality of nursing care and intensive care unit nurses. Iranian Journal of Nursing and Midwifery Research, 21(3), 213-218. Web.