Background
Quality health service is the key intention of all operational health facilities but is hindered by nursing problems. The use of drugs by nurses and medical professionals has become a big issue with nurses and professionals in several operational health facilities. These drugs are being stolen from the facilities and patients. This has led to the development of the PICOT question: In hospital and nursing home settings, how does nurses and professional use of stolen drug and none use impact the quality of services offered to patients?
Articles Support for the Nursing Practice
Addressing this problem is essential for services improvement which is defined as the systematic and sequential events which lead to a certain degree of improvement in the quality of service provided. According to the Institute of Medicine, quality improvement (QI) in healthcare is defined by the relationship between the quality of services given and the expected outcomes (Kim et al. 2017). The use of drugs by the professionals in the health facilities alters their judgment, slows down the response to incidents, and compromises the quality of services offered to the patient.
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The quantitative studies evaluated the prevalence of the drug use in the nursing profession. They evaluated the punitive actions taken against the nurse, how different specialty report varied cases of chemical dependence. The studies used registered nurses in their analysis and engaged different quantitative research approaches to draw results. The articles focused on the incidents of drug use among nurses in different specialties and the history of addiction in the nursing profession. The focus is on how drug use affects the nurses as well as the population they serve.
How Articles Answers PICOT Question
These articles answered the picot question by informing on prevalence rate of the problem, the impacts it has on the patients and the nurses themselves as well as the health facility. By understanding these, it will be used in development on quality improvement strategies that will adequately address the identified problems associated to drug use as they manifest. The use of available research is essential in having a broader perspective about an issue at hand. Tracing the history of addiction in nursing is essential in helping the research to understand the trends of the problem. This is critical in identification of gaps in research and determining what needs to be done to for the efficiency of interventions in helping the impaired nurses.
The qualitative research articles focused on the drivers that push the nurses into drug use. This articles are essential for the research as prior to addressing the problem, one must understand the root causes to ensure absolute correction. The two articles used answer the PICOT question as one focuses on the prevalence of the problem to the nursing community, how it affects them, the facility they work for and the patients they serve and the implications they encounter in relation to their profession. In the second article, it analysis the work schedule of the nurses and how they play a role in the development of substance use dependence in the nursing population.
In all the articles used for the research, the comparison groups are the nurses, health facilities and the patients. These three aspects are crucial in the PICOT question as they act as the basis for finding the solution. The articles demonstrate the ways used for addressing the problem of drug use and use of disciplinary measures, admission to substance use facility, recommendation of change in working shift so that the service delivery is not draining to the nurse. These are in agreement with the PICOT question as the questions seeks to understand the problem of drug use and how the impact the quality of services offered to the patient.
The evaluated articles used survey, and ethnographic research methods. This methods differ in that the survey allows the collection of data from a large population. This allows the researcher to draw their own conclusion based on what their responded gives back as feedback. The ethnographic research entails the use of a nursing population that are struggling or recovering from drug use. This acts as a guide to understand the problem from the nurse’s perspective which is essential for the development of the interventions to enhance acquisition of the desired quality of health services.
Methods of Study
Ethnographic Research and Survey Method
Ethnographic research allows the immersion into the victims’ life and it is essential for the identification of the needs that would otherwise not be articulated. Nurses’ drug use is a known problem, but understanding the drivers is pivotal for the management of the problem as well as eradication. The efficiency of this research method is dependent on the knowledge of the researcher and availability of time as it is time consuming.
Survey allows the researcher to reach out to a large population and thus allows acquisition of vast information. It is cost effective and can be done using different methods. It is faced with limitations such as varying levels of understanding of questions which can result to giving wrong or dishonest answers. The participants can also decide not to answer all questions or give wrong information regarding the issue.
Results of Study
The research evaluated raised varying concerns concerning the nursing problem of drug use. The articles demonstrated the use of different drugs and the variation with respect to the specialties chosen by the nurses. It was also clear that drug use contributed to the nursing shortages as those got using drugs end up losing their licenses.
It is important to note that, nurses use drugs due to different factors which ranges from, accessibility to the drugs and thus the need to experiment, the working schedule of nurses is strenuous and thus turn to drugs for comfort. Despite the reason for drug use, the impacts are the same as they alter the nurses judgment, slows down the response to incidents and its costly to the facility due to the high employee turnover, compromised integrity and unsatisfactory services to the patients. The interventions used such as punitive actions against nurses has not been efficient due to the increase in the prevalence of the problem. With this in mind, the use of other corrective actions can be more effective such as addressing the drivers to drug use as well as rehabilitating the nurses got up in the nursing problem.
Implications of the study to the Nursing Practice
The reviewed articles have implications to the nursing practice. They indicate how the problem of drug use is widely spread and how it compromises the quality of services offered to the patients. The nursing shortage arising from punitive actions against the nurses depending on drug further affects the efficiency of the remaining nurses as they will need to work longer hours, this makes them vulnerable to drug use too and thus the continuation of the cycle (Monroe, Frances, & Kenaga, 2008) . To be able to address the problem, the findings from the recovering nurses and all other nurses should be considered.
Ethical Considerations
Ethical considerations as essential in the success of any research. Informed consent is vital in conducting research. This ethics demands that the participants are informed of the objective of research and allowed to make decision of whether to participate or not as they cannot be coerced into participation. Anonymity and confidentiality of the participants is an ethical consideration that requires the researcher not to disclose personal information of the participants to the third party. This is critical that no harm is done to them as being part of a research such as being implicated based on the information that they share (Fouka & Mantzorou, 2011).
In the articles evaluated, ethical considerations were applied. Anonymity helps in ensuring that the participants are not implicated by the information they shared in the research. The disclosure of the facilities the nurses worked with would have raised the incident of them being targeted. The protection of the participants increased the validity of the information as they did not have any fear to be harmed by the authorities such as the nursing councils. The use of anonymous mail adheres to the ethical consideration of not harming the participants. It also represents the truthfulness and confidentiality ethics. This implies that all the respondents don not have to share their personal details even to the researcher. This increases the credibility of the information gathered as the participants are comfortable and assured of their protection.
Outcomes Comparison
The PICOT expected outcomes are low quality services, inefficiency of the nurses who uses drugs compared to those who does not and economically strained facilities. As the nurses engage in drug use, the facility need to hire their replacement and participate in their disciplinary actions. On the other hand, the patient’s satisfaction is compromised because of the high workload and working hours of the available nurse, mishandling of the patients by the drugged nurses and altered assessment of nurses leading to misdiagnosis.
The outcomes in the articles relate to the anticipated outcomes because, drug use leads to loss of nurses (dismissal) from duty and those increasing the work load of the available nurses. The specialty of nurses also relate to the incidents of drug use, this is an indication that some departments might be more affected by drug use as compared to others arising from the difference in the schedule and workloads.
References
Fouka, G., & Mantzorou, M. (2011). What are the Major Ethical Issues in Conducting Research? Is there a Conflict between the Research Ethics and the Nature of Nursing. Health Science Journal, 5 (1), 3-14.
Kim, Mi Ok, Enrico Coiera, and Farah Magrabi., (2017). “Problems with health information
Technology and their effects on care delivery and patient outcomes: a systemic review. Journal of the American Medical Informatics Association, 24(2), 246-250.
Monroe, T., Kenaga, H., Dietrich, M., Carter, M., & Cowan, R. (2013). The Prevalence of Employed Nurses Identified or Enrolled in Substance Use Monitoring Programs. Nursing Research, 62 (1), 10-15. doi:10.1097/NNR.0b013e31826ba3ca
