Problem Statement Worksheet-Solution Example

NSG 301 Problem Statement Worksheet

1. What is the primary problem in the essay?

The essay addresses medication administration errors. Medication administration errors include administering the wrong dose or route and administering the wrong drug to the wrong patients or at the wrong time. Dose ommissions and lack of documentation are also considered medication administration errors. The five rights, that is, right patient, medication, time, dose, and route, are taught in the nursing curriculum. Nurses should identify and prevent these errors to promote patient safety. Medication administration errors can also be system generated attributed to inadequate training, system misconfiguration, distractors, and convoluted processes. Other factors associated with an increased probability of medication administration errors include burnout, work-related stress, frustrations, and lack of engagement.(Problem Statement Worksheet-EssaySample)

3. What other problems are mentioned in the essay or are related to the central problem? (Name at least 1, at most 3.)

The essay also mentions other nursing problems, including burnout, work-related stress, and lack of engagement. Nurse burnout encompasses emotional exhaustion, frustration, and lack of motivation. Causes of work-related stress include working overtime, heavy workload, conflicts with colleagues, and job insecurity. Lack of engagement involves a lack of commitment to and satisfaction with the job linked to factors such as heavy patient workloads and inadequate managerial support and communication.(Problem Statement Worksheet-EssaySample)

3. What are other problems of interest to you? (Name at least 1, at most 3.) These can be completely unrelated to your personal essay. It’s your chance to change topics, if you want.

Work safety and inadequate staffing are problems of interest because they significantly impact nursing practice. Inadequate staffing leads to heavy patient workloads and long working hours. Work safety is associated with risks and hazards, including the possibility of infections, that impact nurses in their jobs. Hospitals should promote workplace safety to increase job satisfaction and commitment to patient care.

Answers You Already Know

1. Briefly describe the problem as it affects the specific population that you know (from your own experience, observation, or reading) is affected by this problem. Make sure you name the specific population. (Don’t discuss any solutions yet, just the problem.)

Everyone taking medication is considered a vulnerable population at risk of medication administration errors. However, there are some populations perceived to be at a higher risk of experiencing these errors, including elders, children, and those with limited language skills, especially English and health literacy. The elderly population is significantly at risk, particularly those taking multiple medications. Surgical, intensive care and emergency care patients are also at increased risk of experiencing medication administration errors.(Problem Statement Worksheet-EssaySample)

1. Why is it important that this problem be addressed now?

Medication administration errors are associated with adverse drug events, complications, patient morbidity, and mortality in worse-case scenarios. These errors also affect the hospital’s and providers’ reputation and increase high institutional and healthcare system costs. Addressing medication administration errors would help prevent adverse drug events, complications, morbidity, and mortality. It would also promote a positive image of the hospital and healthcare providers and help reduce healthcare-related costs.

1. What is the current practice/protocol in your workplace?

Current practices to limit and prevent medication administration errors at the workplace include standardized communication, optimizing nursing workflow, and focusing on high agents. The organization has also adopted computerized physician order entry to reduce the risk of medication administration errors.

Asking Questions About What You DON’T Know

1. What causes the problem? Consider the factors that create or exacerbate the problem. Some you may know. Others might be speculation. Write at least 3 questions about possible causes. (Try the formula: Is ____ a cause of [the problem]?)

Examples: (If my topic/problem is “violence in the E.D.”) 1. Do long E.D. wait times make patients more likely to become violent? 2. Do drug-seeking patients cause the majority of E.D. violence? 3. Do staff attitudes provoke violent reactions?

1. What work-related factors cause medication administration errors?
2. What individual-related factors increase the risk of medication administration errors?
3. What system-related factors increase the risk of medication administration errors?
4. Are managerial and leadership comptenecies linked to medication administration errors?(Problem Statement Worksheet-EssaySample)

1. What are the effects of the problem? Some you may know, while others may be predictions. Write at least 3 questions about possible effects. (Try the formula: Does [the problem] cause ____?)

Examples: (If my topic/problem is “violence in the E.D.”) 1. Does E.D. violence cause the hospital to lose money? 2. Does violence make it harder to retain E.D. nurses compared to other units? 3. If E.D. violence continues, will patients be afraid to seek help?   

1. Do medication administration errors increase morbidity and mortality rates in the healthcare facility?
2. Are medication administration errors associated with long hospital stays, patient readmissions, and adverse drug events observed at the healthcare facility?
3. Is there an association between hospital ratings and medication administration errors?
4. Do medication administration errors affect relationships between healthcare providers and their patients?

1. Write at least 4 factual questions about your topic. If I knew nothing about your topic, what questions would I ask about it? Make a list of specific questions that ask: Who? What? When? Where? (Do not ask questions about causes or effects, since you’ve already covered that.) 

Examples: (If my topic/problem is “violence in the E.D.”) 1. Who are the usual perpetrators and victims of E.D. violence? 2. When do most violent incidents occur? 3. How often do they occur? 4. Where is risk the greatest (in waiting room or exam area)? 5. What are some security precautions taken in the E.D.? Etc.

1. Who are associated with a high rate of medication administration errors at the healthcare facility?
2. What time of day is associated with most medication administration errors?
3. In which departments are the risk of medication administration errors the greatest?
4. How often are medication administration errors at the workplace?
5. What safety precautions are applied to address medication administration errors at the workplace?(Problem Statement Worksheet-EssaySample)

1. You’ll also need to know the scope of the problem. Since the questions are likely to be the same for everyone, I’m just going to give you the questions and ask you to either speculate about the answers or respond “I don’t know.” Remember that it is OK to recognize gaps in your knowledge!

   1. Other than the population mentioned in your answer to question D above, who else might be affected by this problem?

The essay focuses more on the elderly population, which is at risk of experiencing medication administration errors. However, children, immigrants with limited English skills, and health-illiterate individuals are also at an increased risk of experiencing medication administration errors.(Problem Statement Worksheet-EssaySample)

1. Is this problem limited to your unit, your institution, your region, N.Y. state, the U.S.? Is it a global problem? Is it a particular problem in certain settings (such as rural hospitals, urban communities, developing nations, etc.)?

Medication administration errors are not limited to specific settings because they are reported at every healthcare facility. These errors are universal, with the only difference being the rate at different healthcare facilities.

1. How long has this problem been occurring or acknowledged as a problem in the academic conversation?

Medication administration errors have been around since drugs were created to address healthcare problems. Medication administration errors are recognized in academic conversations throughout medicine, nursing, and healthcare delivery.

1. What is being done to address this problem in other places?

Medication administration errors impact patient safety, and the primary focus of healthcare reforms is promoting patient safety. Evidence-based interventions to reduce medication administration errors at the moment include staff training, standardized labelling, and clear storage requirements. Technological interventions include clinical decision support strategies and computerized physician order entry systems. Electronic health records also facilitate efforts to reduce medication administration errors by providing the correct and timely information to support prescription and administration.(Problem Statement Worksheet-EssaySample)

Create a Problem Statement

1. Look at everything you have highlighted in the sections above. Identify key words or short phrases that might be valuable search terms. (For example, “E.D. wait times” and “patient violence” would be good selections from the example sentence above.) Copy and paste ALL the key words and phrases here: (1 problem from A-C; 1-3 keywords from D-F; 1-3 points from G-J)

Phrases and Keywords

1. The five rights of medication administration: The right patient, medication, time, dose, and route.
2. Medication administration errors among older adults
3. Association between medication administration errors and adverse drug events, complications, patient morbidity, and mortality.
4. Standardized communication and workflow optimization role in reducing medication administration errors.
5. Work-related factors associated with medication administration errors.
6. The prevalence of medication administration errors at the workplace.(Problem Statement Worksheet-EssaySample)

1. Make a claim about your problem. A good approach is to answer the question: What’s bad about the problem? The claim cannot be personal in nature, but it may be specific to your unit/institution. (If it’s specific to your workplace, name the specific place instead of using first person pronouns. For example, “the E.D. at Highland Hospital” is good, but “my unit” is not.) Incorporate at least 2 of the keywords or phrases from your response to question K. You may include speculative details in your claim (you can always revise if the research doesn’t support the claim. Example: Excessive wait times in the E.D. increase the likelihood that patients will become violent.) Write only ONE SENTENCE and keep it short and simple:

Medication administration errors increase the risk of adverse drug events, complications, patient morbidity, and mortality.