I need help with the following questions below for a article analysis. See below article for reference.

1 - What are the independent and dependent variables and type of data for the variables?

2 -Descriptive Statistics(Mean, Median, Mode; Standard Deviation) - Identify examples of descriptive statistics in the article.

3 - Inferential Statistics- Identify examples of inferential statistics in the article.

RN Perceptions of Medication Administration and Medication Errors: Results from a Quantitative Nursing Research Study Dougal, Renae L, PhD 1 1 Faculty &Clinical Coordinator, Idaho Alliance of Leaders in Nursing, Nurse Refresher Program Nurse Leaders of Idaho, Boise, RN Idaho ; BoiseVol.43,Iss.1,(May-Jul 2020): 7-9.

ABSTRACT (ENGLISH) The nursing profession's core values are the foundation of the delivery of nursing services (e.g., direct patient care, health promotion, coordination of care, patient education) (NCSBN, 2018a) whether one practices in hospitals, public health centers, schools, homes, or long-term care facilities. Method Research Design A quantitative nonexperimental study design was utilized to describe and understand relationships of the phenomena of interest: RN perceptions of risk associated with medication administration and medication errors, and the relationships between the demographic factors and outcome variables. Data Analysis Quantitative data from demographics, inquiry of medication errors, perceived frequency and perceived caution of risk, the test-retest survey, and the pharmaceutical questionnaire on medications were analyzed using IBM SPSS v25 and SAS Institute Inc., JMP v14. [...]there was a noted difference in RNs that would actually report the medication error and adverse events associated with medication errors that participants attributed to fear of job loss, retaliation, shame, blame, and/ or guilt.

FULL TEXT The nursing profession's core values are the foundation of the delivery of nursing services (e.g., direct patient care, health promotion, coordination of care, patient education) (NCSBN, 2018a) whether one practices in hospitals, public health centers, schools, homes, or long-term care facilities. Nurses are expected to practice within their scope of practice to the full extent of their education and training, remain competent, and place first the patients' best interest and safety while optimizing efficient and quality care (IOM, 2015; IOM, 2010; NCSBN, 2018a). Inherent in this quality of care conversation is the avoidance of adverse events and potential harm to patients (Codier &Codier, 2017). Medication errors are adverse events that can harm patients; therefore, reporting a medication error is relevant communication among health care colleagues about the adverse event. Nurses should recognize and report medication errors, whether the nurse is the source of the error, contributes to the error, or observes a medication error. But, whether nurses report the error depends on attitudes, decisions, and contextual experiences (Yung, Yu, Chu, Hou &Tang, 2016). Nurses spend as much as 40% of their time administering medications (Cheragi, Manoocheri, Mohammadnejad &Ehsani, 2013; Hughes, 2008) and are responsible for 26% to 38% of medication errors in hospitalized patients (Elliott &Liu, 2010). Inherent to safe medication administration is the perception of risk which can influence a nurse's clinical decision-making regarding safe practices (Hughes, 2008). The purpose of this paper is to present partial findings from a nursing study that was designed to explore RN perceptions of medication errors (adverse events) and medication administration practices, specifically related to risk, benefits, frequency, and cautions.

Research Questions Three questions guided this study: PDF GENERATED BY PROQUEST.COM Page 1 of 8 Research Question 1) Do nurses perceive risk in medication administration in everyday practice? Research Question 2) How is an RN's self-reporting behavior related to medication administration errors and risk? and Research Question 3) Do nurses perceive benefit and risk to medication safety during the medication administration process?

Theoretical Foundation The selected framework for this nursing study was that of descriptive theory, in order to provide meaning and explanation of cognitive perception as it correlates with nursing medication errors. Three nursing theories (Levine's Conservation Principles, Neuman's System Model, and Benner's From Novice to Expert) were included within this study's theoretical foundation.

Method

Research Design A quantitative non-experimental study design was utilized to describe and understand relationships of the phenomena of interest: RN perceptions of risk associated with medication administration and medication errors, and the relationships between the demographic factors and outcome variables.

Sample The target population encompassed RNs who were licensed and worked in two states of the Pacific Northwest region of the U.S. The study population encompassed RN members of ANA-Idaho and RNs licensed in Oregon. Emails which were on file with ANA-Idaho and the Oregon State Board of Nursing database were utilized.

Recruitment After IRB approval and prior to participant recruitment, informed consent was obtained from each participant before information was obtained. Emails were sent (N=44,095) to invite participants of the study population. Inclusion criteria. RNs were required to be licensed in the State of Idaho and/or the State of Oregon, be >18 years of age, and able to self-report an ability to read/ speak English.

Exclusion criteria. Licensed Practical Nurses, Advanced Practice Registered Nurses, nurses <18 years of age, and self-reporting an inability to read/speak English were excluded. The researcher recruited a sample size (N=2306) with actual completers (clean data) (N=1475) for the initial RN online survey. Participants completed and submitted the online survey through the Qualtrics (Q qualtrics) software program through the Idaho State University website. Study participants were offered the opportunity to participate in a drawing of four Amazon gift cards ($25 each) as a small token of appreciation for participation. All participants were also offered the opportunity to participate in a testretest online survey two weeks after the initial survey. Completers of the test-retest survey were provided the opportunity to participate in a drawing of four Amazon gift cards ($10 each). Participant confidentiality was maintained throughout data collection and analysis.

Instruments The online survey questionnaire was a data collection instrument comprised of four-sections. The first section consisted of 18 demographic questions and the second section consisted of 13 questions in Likert scale format designed to address participant perceptions of fear or support in the workplace. The third section was a previously studied tool with six questions in Likert scale format that measured risk regarding perceived frequency and perceived caution with regard to medication errors in a typical clinical nursing unit. The final section, a pharmaceutical questionnaire, asked study participants to identify risk and benefit of each medication listed.

Data Analysis Quantitative data from demographics, inquiry of medication errors, perceived frequency and perceived caution of risk, the test-retest survey, and the pharmaceutical questionnaire on medications were analyzed using IBM SPSS v25 and SAS Institute Inc., JMP v14. Statistical tests used for this descriptive correlational analysis included parametric and nonparametric tests (Pearson r, Spearman's rho, Chi-square). Statistical significance was 0.05.

Results and Discussion

Demographics PDF GENERATED BY PROQUEST.COM Page 2 of 8 As shown in Table 1, a majority of the participants were bachelor's degree prepared white female RNs who were married, in their late forties and were working full time in nursing as staff nurses. Over 90% (n=1333) of participants were licensed in Oregon and almost 72% (n=1056) were employed in the state of Oregon. Less than 3% (n=43) of participants worked in Idaho, and 2.17% (n=32) worked in both Idaho &Oregon. Participants worked in a wide variety of clinical settings.

Analyses of RN Perceptions Do nurses perceive risk in medication administration in everyday practice? Most RNs reported by a seven point Likert scale ("not at all likely" to "very likely") that they were "not at all likely" to report medication errors (n=706, 47.9%) and believed they do not make errors in medication administration or are "unlikely" to do so within the next 12 months. They believed their peers were "very likely" (n=324, 22%) to make errors in medication administration within the next 12 months. There was not a strong relationship between the number of years one has been an RN and perceived risk or benefit in medication administration. How is an RN's self-reporting behavior related to medication administration errors and risk? RNs are required to report medication errors whether to their manager, charge nurse, supervisor, or provider, and are required to report medication errors via an institutional reporting system. However, there was a noted difference in RNs that would actually report the medication error and adverse events associated with medication errors that participants attributed to fear of job loss, retaliation, shame, blame, and/ or guilt. RNs reported they were "not at all likely" to make medication errors in the next year (n=706, 47.9%); however, they indicated their peers were "very likely" to make medication errors in the next year (n=324, 22%). Although RNs reported knowing it to be their ethical responsibility to report medication errors, they reported willingness to take a risk and not to report. This behavior can potentially increase a risk of recurrence of medication errors because contributing and causative factors are not reviewed and analyzed as is done routinely through discussions of root cause analysis and improvement processes. As shown in responses for survey question 2 in Table 2, the most common reason RNs do not report medication errors is "not knowing one has occurred" (n=480, 32.5%). The second most common reason is "fear of retaliation" (RNs 32.1%; peers 28.3%).

RN Perceptions of the Medication Administration Process Participants identified the rights of medication administration are generally not followed during the medication administration process; they identified that self-reported distractions, interruptions and multi-tasking during the medication administration process interfered with administration of the medication(s). Multi-tasking was reported as lending itself to distractions and interruptions by colleagues, staff and families; these contribute to errors during the medication administration process. Nurses do work-arounds which are justifications or excuses of why the process or policy of medication administration was not followed. These distractions and work-arounds result in administering medications late or contribute to errors. Participants identified issues contributing to medication errors such as short staffing, high-acuity patients, high nurse to patient ratios, as well as trying to finish everything during the clinical shift.

RN Perceptions of Reporting Medication Errors Participants identified nurses are fearful of reporting or admitting to an error because they are fearful of reactions from colleagues, managers, or physicians as well as the patient and/or patient families. Nurses are also fearful of shame, guilt, blame, loss of job as well as retribution and legal retaliation. Participants identified not all work environments are supportive of reporting errors and even discourage nurses from reporting. Importantly, participants also identified lack of knowledge or understanding as to what constitutes a medication error or near miss and may not recognize that a medication error has even occurred. Nurses alluded to the concern, "If there is no harm, why report the medication error or near miss"? They viewed time is of the essence with little time to get everything done during their shift, especially little time to report near miss events. Participants identified communication and reporting of medication errors as crucial to decrease medication errors, thereby improving patient-centered care and patient safety. Following the rights of medication administration, with PDF GENERATED BY PROQUEST.COM Page 3 of 8 every patient and every single drug, every encounter is a system process designed to decrease risk for the patient and the RN. Communication also involves the utilization of technology processes (e.g., EHR, barcode scanning, institutional reporting systems) within the workplace environment. Nursing managers must investigate medication errors that involve nurses; if not communicated and/or reported, managers cannot do their job, detracting from patient safety.

RN Understanding of Human Factors Associated with Medication Error Reporting An underlying issue throughout the self-reported responses, even though not completely understood by the RN or recognized within themselves, was the human factor component. Nurses need to reflect on one's individual performance and report medication errors no matter why the medication was administered late, omitted or a near miss. However, in order to report, one must understand what a medication error is and why it is necessary to report them. Reporting can identify and perhaps solve human factor issues and system processes that support the nurse when administering medications rather than place blame on the nurse.

Regarding Research Question 1. Do nurses perceive risk in medication administration in everyday practice?, participants perceive that medication errors occur weekly if not more often, and yet report they are not very likely to report medication errors for reasons of fear, blame, retaliation, not knowing what constitutes a medication error or knowing if one has occurred, even though they are required to report medication errors. Participants identified they are not likely to make medication errors in the next 12 months yet identify they may not know they have caused or contributed to a medication error. Complacency with reliance on technology (e.g., barcode scanning) to catch all issues/potential errors with the medication process is a risk in everyday practice. Nurses that do not follow the rights of medication administration each and every time, create work-arounds which contribute to medication errors. The idea that barcode scanning replaces the rights of medication administration needs to be addressed in clinical settings in order to decrease risk and medication errors. Complacency can interfere with strategies (e.g., double check) while in the medication administration process. One's trust of the barcode scanning system helps to decrease errors however, the rights of medication administration still need to occur, as the rights of medication administration along with the barcode scanning system are the process.

Regarding Research Question 2. How is a(n) RN's self-reporting behavior related to medication administration errors and risk?, nurses allude, if there is no harm, why then report the medication error. Participants identified they are more afraid of the repercussions to them from a workplace environment and their job, than reporting medication errors even though their ethical and professional duty. The self-report reflects that there is an inherent risk when one does not report medication errors. The perception of, no one will know or why report on myself rather than saying, I do not want this error to happen again, should be of interest to the nursing profession as well as their workplace colleagues and/or managers. Open communication why an error happened and how the problem can be addressed or fixed, no matter the issue (e.g., clinical, technological, system or of some other nature) needs to be identified however, without reporting, the discussion cannot ensue. We must also identify if medication errors are made by newer RNs while supporting them in furthering their knowledge of the medications they administer.

Study Limitations Three limitations in the study were identified. First, this study may not be generalizable to all 50 states and U.S. territories, as the sample was selected from two states in the Pacific Northwest region. Due to the large randomly selected sample size and a percentage of participants reporting current active licensure in other states and U.S. territories, and current employment in other U.S. states, U.S. territories, and foreign countries, it is possible the study may be generalizable to RNs throughout the mainland U.S. and U.S. territories. Second, this study was a web-based online survey and there is a risk to reducing survey response. Third, the study was cross-sectional, describing relationships among phenomena at a fixed point in time.

Conclusions/Implications Conducting a study of RN understanding that medication errors correlate with perception of risk contributes to valuable evidence to inform nursing practice. Statistical findings related to RN perception and thinking during and PDF GENERATED BY PROQUEST.COM Page 4 of 8 prior to medication administration contribute to clinical and curricular relevance. The Administration and Medication Errors: Results from a Quantitative Nursing Research Study continued from page 8 statistical significance of this nursing study infers clinical relevance because RNs voluntarily reported they were much more cautious compared to their peers in medication administration and "not at all likely" to make a medication error in the next 12 months. Yet they reported their peers were "very likely" to make a medication error in the next 12 months. Participants reported they are required to report medication errors but are not "very likely" to report medication errors due to fear of blame for the medication error. Not reporting reflects a cultural shift that needs to occur in the workplace environment; the shift needs to be one that supports the RN when errors occur. Participants reported medication errors "occur often" yet they are afraid to report the medication error. Deviation from institutional policy regarding medication administration and lack of reporting medication errors are unsafe practices which do not support good clinical decision-making. Reporting and communicating medication errors is our ethical duty. This study filled a gap in the research literature related to the persistent risk of RNs, knowingly or unknowingly, making a medication error. This study focused on RN perceptions and thinking during and prior to medication administration. The findings are prompts for creating and implementing improved RN decision-making tools to decrease risk and enhance patient safety. Educators (e.g., Academic faculty, hospitals) should consider broadening their pedagogies and clinical interactions related to medication administration, thereby further reducing medication errors because of improved RN decisionmaking at the point of care.