Title of Project
Presenter Name
University name
Introduction and Problem
Several studies have shown the benefits of the use of
electronic health records (EHR) for patients safety, as well as
their ability to improve efficiency in primary care settings
(Porterfield, Engelbert, & Coustasse, 2014). Regardless of
the positive effects of the implementation of EHR, health care
providers have moved slowly to adopt this technology (King,
Patel, Jamoom, & Furukawa, 2014). Practitioners who do not
want to adopt EHR, especially electronic prescription, can
endanger patient safety.
Medication errors, in turn, are a serious issue that causes
numerous safety incidents in primary care. Studies have
shown that the use of EHR significantly reduces the number
of prescription errors that can harm patients (Liao et al.,
2017). Palabindala, Pamarthy, and Jonnalagadda (2016)
showed that the use of EHR could reduce medication error
while also resulting in improved communications between
patients and healthcare teams
Purpose of the Project
The purpose of this quantitative quasi-experimental project
was to determine if there was a relationship between the
application of an educational program and the improvement
of practitioners perception of EHR usability, as well as the
reduction of the number of prescription medication errors,
at a medical group practice in the Southeastern of the
United States (US).
Clinical Questions/PICOT
The PICOT question created for the project was as follows:
(P) Among healthcare practitioners, (I) how does the
implementation of an educational program in a primary care
medical center in the Southeast of the US (C) compared to
the pre-intervention measurements in the prior four weeks
(O) influences primary care practitioners perceptions of the
usability of EHR and the incidence of prescription
medication errors (T) within four weeks of participating in
the program?
The following clinical questions guide this quantitative
project:
Q1: How does the implementation of an educational
program influence the perceptions of primary care
practitioners regarding EHR usability?
Q2: How does the implementation
Variablesof an educational
program influence prescription medication error incidence?
Variable 1: Quality improvement educational program
(independent)
Variable 2: Primary care practitioners perception of EHR
usability (dependent)
Variable3: Number of prescription medication errors
(dependent).
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Results (cont.)
Data Analysis
The data analysis was in line with the needs of the project:
statistical tests, including t-test and Wilcoxon signed ranks,
were employed to determine if there were statistically
significant differences between pre- and post-test
measurements. This way, the relationships between the
independent and dependent variables were reliably inferred
(Polit & Beck, 2017)
Data types:
Survey: quantitative, ordinal (Likert scale).
Reports: quantitative, ratio (number of mistakes).
Data analysis approaches:
Software: SPSS.
Survey: Wilcoxon signed ranks test.
Reports: paired t-test.
Descriptive Data
Figure 3.
Gender of
the
participant
s.
Figure 1. The
occupations
of the
participants.
Figure 2.
Age of the participants.
The project employed four Advanced Practice
Registered Nurses, three Medical Doctors, and one
Physician Assistant who exhibited significant resistance
to the use of EHR.
Results
.
As had been
planned, the data
were collected
before and after the
intervention using
an already
established survey
tool and the clinics
pharmacy call
reports regarding
medication errors.
Table 1
Survey Summary
Item
Pre-Test
Post-Test
Mean
St. Deviation
Mean
St. Deviation
Q1
2.25
0.707
4.75
0.463
Q2
2.13
0.991
4.38
0.744
Q3
1.75
0.707
4.38
0.744
.
Total Errors Analysis Results: Paired Samples Test
Sig. (2-tailed)
Figure 4. Example changes in survey results before and after the
intervention.
Example changes in pre- and
post-test scores can be
found in Figure 4. Table 2
summarizes the results of
analyzing the survey items
with the Wilcoxon signed
ranks test. Items 1, 3, 4, 5, 6,
7, 8, 9, and 10 demonstrate
statistically significant results
(p0.05). Thus, the findings do not suggest that the
program had an impact on medication error rates; a
relationship between the independent variable and
medication errors was not found.
Q2
Number
31
.846
0.04
Error Data Summary
Total
.587
Pair 2
Q1
Table 3
Error Type
Pair 1
Table 2
Incorrect Drug
The survey contained 11 individual items and used a
Likert scale in which 1 stood for an extremely
negative assessment of an aspect of usability or
usefulness and 5 referred to an extremely positive
one. The summary of the mean and standard
deviation for each of the items before and after the
intervention is presented in Table 1.
Discussion
Table 4
32
2. The data collection process was limited by the short
time allocated to observing the results (4 weeks)
3. The project employed a quasi-experimental design.
Since its sample was so small, trying to split it further
was not feasible.
. The raw
data indicate
that the most
common
errors for the
clinic include
incorrect
dosage,
incorrect
drug, and
drug-drug
interaction,
as well as
incorrect
frequency
and drug
omission.
Some of the research recommendations include the proposal
to increase the sample size, have a greater timeframe for
future projects, and consider randomizing the sample into
two groups.
The project can also be used to recommend educational
EHR efforts for the reduction of EHR resistance and the
References
specific program that has been tested for the same purpose.
King, J., Patel, V., Jamoom, E. W., & Furukawa, M. F. (2014). Clinical benefits of electronic
health record use: National findings. Health Services Research, 49(1pt2), 392404. doi:
10.1111/1475-6773.12135
Liao, T. V., Rabinovich, M., Abraham, P., Perez, S., DiPlotti, C., Han, J., … Honig, E. (2017).
Evaluation of medication errors with implementation of electronic health record technology in
the medical intensive care unit. Open Access Journal of Clinical Trials, 9, 31-40. doi:
10.2147/OAJCT.S131211
Porterfield, A., Engelbert, K., & Coustasse, A. (2014). Electronic prescribing: Improving the
efficiency and accuracy of prescribing in the ambulatory care setting. Perspectives in Health
Information Management, 2014, 1-13
Palabindala, V., Pamarthy, A., & Jonnalagadda, N. R. (2016). Adoption of electronic health
records and barriers. Journal of Community Hospital Internal Medicine Perspectives, 6(5), 13. doi: 10.3402/jchimp.v6.32643
Polit, D.F., & Beck, C.T. (2017). Nursing research: Generating and assessing evidence for
nursing practice (10th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Poster Presentation
Students this project will allow you to formulate and hypothetically develop your own research project. The purpose
of this project is for the student to follow all of the different steps in a research project on an already published article
and presented as a poster presentation. A poster session or poster presentation is the presentation of research
information by an individual or representatives of research teams at a congress or conference with an academic or
professional focus. The work is usually peer reviewed. Poster sessions are particularly prominent at scientific
conferences such as medical congresses.
Students will select a nursing research already published and following the article information you will create a poster
presentation that include the below information:
The outline of the poster should include the following tabs (minimum requirements)
Abstract Outline:
-Title of Project
-Problem Statement: what is the problem that needs fixing?
-Purpose of the Project
-Research Question(s)
-Hypothesis
-Methodology (Qualitative vs. Quantitative)
-Steps in implementing your project
-Limitations
Results (Pretend results)
-Conclusion
-References
I have attached an example of a poster presentation for guidance. The due date for the poster presentation is WEEK
13. Please feel free to be artistic and provide graphs and data. You are welcome to use any poster template. Please
submit it via turn it in.
Criterion
Completeness
Outstanding 4
Complete in all
respects; reflects all
requirements
Understanding
Demonstrates
excellent
understanding of
the topic(s) and
issue(s)
Analysis
Evaluation
Opinion
Very Good 3
Complete in
most respects;
reflects most
requirements
Demonstrates an
accomplished
understanding of
the topic(s) and
issue(s)
Good 2
Incomplete many
respects; reflects
few requirements
Presents an
insightful and
through analysis of
the issue (s)
identified
Makes appropriate
and powerful
connections
between the
issue(s) identified
and the concept(s)
studied
Presents a
thorough
analysis of most
of the issue(s)
identified
Makes
appropriate
connections
between the
issue(s)
identified and the
concept(s)
studied
Supports opinion
with strong
arguments and
evidence; presents
a balanced and
Supports opinion
with reasons and
evidence;
presents a fairly
balanced view;
Presents a
superficial
analysis of some
of the issue(s)
identified
Makes
appropriate but
somewhat vague
connections
between the
issue(s)
identified and the
concept(s)
studied
Supports opinion
with limited
reasons and
evidence;
presents a
Demonstrates an
acceptable
understanding of
the topic(s) and
issue(s)
Unacceptable 1
Incomplete in
most respects;
does not reflect
requirements
Demonstrates an
inadequate
understanding of
the topic(s) and
issue(s)
Presents an
incomplete
analysis of the
issue(s)
identified.
Makes little or no
connection
between the
issue(s)
identified and the
concept(s)
studied.
Supports opinion
with few reasons
and little
evidence;
argument is one-
Score
Recommendations
critical view;
interpretation is
both reasonable
and objective
Presents detailed,
realistic, and
appropriate
recommendations
clearly supported by
the information
presented and
concepts studied
Grammar and
Spelling
Minimal spelling
and grammar errors
APA guidelines
Uses APA
guidelines
accurately and
consistently to cite
sources
interpretation is
both reasonable
and objective
somewhat onesided argument
sided and not
objective.
Presents
specific, realistic
and appropriate
recommendation
supported by the
information
presented and
the concepts
studied
Some spelling
and grammar
errors
Presents realistic
or appropriate
recommendation
supported by the
information
presented and
the concepts
studied
Presents realistic
or appropriate
recommendation
with little, if any,
support from the
information and
the concepts
studied.
Noticeable
spelling and
grammar errors
Uses APA
guidelines with
minor violations
to cite sources
Reflects
incomplete
knowledge of
APA guidelines
Unacceptable
number of
spelling and
grammar errors
Does not use
APA guidelines
Total
1
Understanding Vaccine Refusal: Why We Need Social Media Now
American Journal of Preventive Medicine, 2016, 50(4), pp. 550-552.
Students Name
Institutional Affiliation
Course Name
Professors Name
Date
2
Abstract
In the last century, vaccines saved tens of millions of lives, but today, experts in many
countries see a trend towards refusing vaccination. The World Health Organization (WHO) is
so concerned about this situation that it is included in the list of ten major threats to world
health in 2019 (WHO, 2019). Dredze, Broniatowski, Smith & Hilyard in their article
Understanding Vaccine Refusal: Why We Need Social Media Now confirm anti-vaccination
movement existence, but also tend to question the arguments supporters and opponents use to
persuade the other party. Namely, the researchers concentrate on the anti- arguments; despite
the pro- thoughts are also included to track the discussion stage. However, the essence of the
paper is questioning the conventional research methods, such as phone surveys, as being
effective to assess to the vaccination discussion. Instead, the authors claim that social media
analysis is more acceptable in this particular case since the conflict for the most part happens
in social networks, such as Twitter and Facebook. The authors concentrate on the Twitter
posts analysis since this particular social media contains less privacy setting. At the end, the
authors conclude that using social networks, as the research platform is a useful way to
investigate the nature of vaccination discussion.
The Problem
The key problem of the article under discussion is answering the question of social
media analysis sufficiency for investigating the vaccination discussion. The authors state that
three research questions how does the adherence or refusal of immunization vary by belief,
how do beliefs vary depending on social group and what strategies do the supporters and
opponents most effective use (Mitra, Counts, & Pennebaker, (2016).) cannot be clearly
answered by traditional research methods, such as telephone surveys due to the set of reasons.
The problem is stated rather clearly and is supported by the data from many background
research results. The author did not define the key terms used in the study because
3
conventional language was used in the article design. Hence, the purpose of the study seems
to examine the chosen social media for relevance and validity.
The authors hypothesize that since the discussion happens online, the best way to
examine it is going online. There is no practical value in phoning the respondents and
spending substantial sums of money since the telephone surveys are in their ability to track
changes in nuanced beliefs among different populations over time (Dredze, Broniatowski,
Smith & Hilyard, n.p.). In practice, the answer to the stated problem may be used, and the
authors indicate it themselves, to find a proper strategies and means to communicate the idea
of immunization necessity to the public and end the discussion. The practical importance of
the research is in using the found persuasion strategies and social media overall to popularize
vaccination among all the population. Hence, the authors did a good job on presenting the
problem and proving its practical importance to the reader.
Review of Literature
The paper does not have a distinguished literature review section. One cannot
conclude on the broadness of the review due to its absence, but by using quotes and reference
list it is possible to analyze the choice of sources the authors made. The sources used can be
relatively developed into two categories the one supporting the issue of vaccination as
being a major health concern and those focusing on social media as the research media for the
issue alike vaccination. Overall, the sources used are pertinent to the study. The literature
used is recent – taking into account the article was published in 2016, the reference sources
used are published within five years before. However, there is one source being published in
1999, which may seem irrelevant. They use such an article to support their research method
and show it as being relevant and valid. Nonetheless, the article still seem outdated and there
is a portion of similar researches being more recent to prove the same standpoint. There is no
traces and signs of bias concerning the references used. Overall, the literature used to support
4
the author standpoint is recent (with one exception), pertinent, nonbiased and rather narrow
allowing to assume the substantial preliminary research was performed to support the study.
Design and Procedure
It was mentioned above that there is no distinguished literature review section in the
paper. It should also be noted that there are no sections at all used in the paper narrative,
which hardens the analysis in terms of particular part required for the paper to be called a
research article. Nevertheless, there is a clear understanding of the research design and
methods the author applied to confirm the hypothesis. The research methodology used cannot
be named conventional. It is neither qualitative nor quantitative research design. In fact, it is a
nontraditional combination of both with some aspects of observation and content analysis.
With 50 keywords search, the authors analyzed Twitter posts (Tweets) in connection to the
recent measles outbreak being connected to undervaccination. The researcher also used a
statistical analysis method, namely language processing, to evaluate the tone of Tweet and
the persuasion method used by the respondent. The study design and the study itself can be
called original since many similar studies was conducted, but none of them used social media
as the research media. No pilot study was conducted. Hence, the research stands out by the
design and methods used by the authors.
Another characteristic of the study design is the absence of variables and the sample
in conventional understanding of these terms. Here, the sample is the search results obtained
by using 50 keywords vie Twitter search engine. Indeed, this is not a traditional sample;
hence, the authors did not introduce the variables to apply statistical research methods.
However, the machine classifiers were applied to indicate the polarity of statement, allowing
to distinguish two possible variables that were used for graphic representation of results
pro- and anti- Tweets.
5
Overall, the research procedure structure looked as follows. The authors first applied
the keywords to identify the vaccine-related Tweets. Afterwards they applied the machine
classifiers under supervision to distinguish relevance, sentiment bearing (neutral versus
opinion) and, for those containing an opinion, sentiment polarity (Dredze, Broniatowski,
Smith & Hilyard, n.p.). On this basis, the authors derive a result and composed a graphical
representation of the Tweets concerning vaccination during the measles outbreak in order to
make a conclusion of the method validity.
Data Analysis and Results
The data was analyzed by means of machine classification method and then turned
into graphical form. To create a graph, the Tweets undergone normalization with a maximum
number of Tweets during 140 days of observation period. There were gaps for several days
during the research window. To smooth the gaps the authors used average data obtained in
two surrounding weeks around the missing data day. The obtained graphs represents three
line the overall amount of Tweets, the positive and negative post during the course during
the 8 months around the measles outbreak of 2014. The conclusion made on the graphical
data confirmed the hypothesis of social media analyses being the valid method for vaccine
refusal investigation. Namely, the method is able to solve the stated problem. However,
despite the authors admit the existence of weaknesses for such a method used, they do not
discuss them or provide any insights on how they can weaken the study overall. Despite that,
the results seem satisfactory and support the hypothesis and problem.
Conclusions and Implications
The conclusion of the study is directly derived from its purpose the authors
hypothesized social media analysis as being valid for vaccination refusal investigation and
the results show the researchers were initially right. The main implications indicated is that
the proposed analysis is future compliment for conventional research methods for alike
6
problems existing mainly online. However, these effects do not seem affect the particular
audience of group since being yet theoretical and further research is required. A the end, the
author admit the importance of the research for defining the polarity and persuasion methods
the social networks users utilize towards the opponents and advise turning to social media to
the medical public before the next outbreak occurs.
Overall, the article does not seem invalid or non-trustworthy. The authors in fact
created a new method of assessment, which is less costly, spread to greater amount of
respondents and is comparatively easy to design. However, I agree with the researches that
this method shall be used (a) to assess health issues that occur mostly in social media, such as
vaccination; and (b) it shall accompany the conventional research methods since the
truthfulness of the posts online can be easily doubted and, hence, affect the credibility of the
study overall. Moreover, the article is easy to read, clear, concise and comprehensive. The
disadvantage of the article design is the absence of sections explaining this or that part of the
research conducted and hardening the perception of the article overall. Nevertheless, this
article is an appropriate example of the research study.
7
References
Dredze, M., Broniatowski, D. A., Smith, M. C., & Hilyard, K. M. (2016). Understanding
vaccine refusal: Why we need social media now. American Journal of Preventive
Medicine, 50(4), 550552. doi:10.1016/j.amepre.2015.10.002
Mitra, T., Counts, S., & Pennebaker, J. W. (2016, March). Understanding anti-vaccination
attitudes in social media. In Tenth International AAAI Conference on Web and Social
Media.
Word Health Organization. (2019). Ten threats to global health in 2019. WHO. Retrieved
from https://www.who.int/news-room/feature-stories/ten-threats-to-global-health-in2019
Title of Project
Presenter Name
University name
Introduction and Problem
Results (cont.)
Data Analysis
Discussion
.
Descriptive Data
Project Limitations
Purpose of the Project
.
Clinical Questions/PICOT
Results
Conclusion and Recommendations
.
References
.
Variables
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