Evidence-Based Research Project

(Evidence-Based Research Project)

Student’s Name:

Institution of Affiliation:

Course Code + Course Title

Instructor’s Name:

Assignment Due Date:

Impact of Cognitive Biases on Patient Safety

EBP Project Problem

A sizable majority of diagnostic mistakes in the organization are attributed to cognitive biases or errors in clinical thinking. Despite this understanding, the undergraduate medical curriculum focuses little on teaching cognitive psychology. Reflective practice is encouraged by understanding the causes of these biases and how they affect clinical decision-making (Bhatti, 2018). Cognitive biases are a subject of concern in the medical field. Prior research demonstrated the impact of cognitive biases on decisions that result in errors in other disciplines (e.g., aeronautic industry, factory production). For instance, research looking into failures and accidents found that 50-70% of all electronic equipment failures, 82% of production errors in an unnamed company, and over 90% of air traffic control system problems were partially or entirely attributable to human cognitive variables (Saposnik et al., 2016). Numerous industries have implemented psychological tests and quality evaluation techniques (such as Six Sigma) to lower errors and raise standards. These approaches can be adopted in the healthcare industry to address cognitive biases contributing to errors such as diagnostic inaccuracies and medical errors. (Evidence-Based Research Project)

Stakeholders Involved

Patients, caregivers, clinicians, managers, executives, clinical assistants, and payers are elemental to this EBP project. Patients are the most critical stakeholders because cognitive biases impact them directly. Patients include everyone consuming healthcare services. Healthcare providers are also fundamental in this project because they engage in cognitive biases that impact patients. Healthcare professionals are directly linked to the proposed intervention that they are required to implement to reduce events of cognitive biases that impact patient outcomes and safety. The project requires policymakers’ involvement to define a healthcare delivery framework. Policies will guide practice and help providers identify cognitive biases and how to address them. Payers will be involved in implementing the policy rules. The Joint Commission has consistently reported on cognitive biases in healthcare and will be directly involved in this EBP project. (Evidence-Based Research Project)

Evidence-Based Research Project

PICOT Question

Among nursing professionals, what is the effect of training and education on cognitive biases’ awareness compared with lack of training within 12 weeks? (Evidence-Based Research Project)

Project Objectives

The project seeks to:

Identify widespread and most commonly occurring cognitive biases in the organization
Assess cognitive biases’ influence on diagnostic accuracy and medical errors and impact on patient outcomes
Increase nursing staff awareness of cognitive biases
Reduce diagnostic mistakes and medical errors linked to cognitive biases (Evidence-Based Research Project)

Rationale for the EBP Project

Cognitive biases are becoming more widely acknowledged as factors in patient safety incidents while being inconsistently reported and consequently difficult to measure (Royce et al., 2019). Cognitive biases have been recognized as contributing to various sentinel events among events reported to The Joint Commission, from inadvertent retention of foreign objects resulting from search satisficing, wrong site surgeries resulting from confirmation bias, patient falls due to availability heuristic and ascertainment bias to treatment delays, especially diagnostic errors that may cause a delay in treatment associated with anchoring, availability heuristic, framing effect and premature closure (Balakrishnan & Arjmand, 2019). Studies have shown that diagnostic mistakes account for 6–17 percent of unfavorable hospital occurrences, and those cognitive biases account for 28% of diagnostic mistakes (Rogers et al., 2022). Sadly, most providers do not recognize when they engage in cognitive biases, making it difficult to determine cognitive biases contributing to the particular event they are involved in. This project seeks to identify the commonly occurring cognitive biases and educate staff on cognitive biases, intending to increase staff awareness of them and how to avoid or address them. (Evidence-Based Research Project)

References

Balakrishnan, K., & Arjmand, E. M. (2019). The Impact of Cognitive and Implicit Bias on Patient Safety and Quality. Otolaryngologic clinics of North America, 52(1), 35–46. https://doi.org/10.1016/j.otc.2018.08.016

Bhatti A. (2018). Cognitive bias in clinical practice – nurturing healthy skepticism among medical students. Advances in medical education and practice, 9, 235–237. https://doi.org/10.2147/AMEP.S149558

Rogers, J. E., Hilgers, T. R., Keebler, J. R., Looke, T., & Lazzara, E. H. (2022). How to mitigate the effects of cognitive biases during patient safety incident investigations. Joint Commission Journal on Quality and Patient Safety, 48(11), 612-616. https://doi.org/10.1016/j.jcjq.2022.06.010

Royce, C. S., Hayes, M. M., & Schwartzstein, R. M. (2019). Teaching Critical Thinking: A Case for Instruction in Cognitive Biases to Reduce Diagnostic Errors and Improve Patient Safety. Academic medicine : journal of the Association of American Medical Colleges, 94(2), 187–194. https://doi.org/10.1097/ACM.0000000000002518

Saposnik, G., Redelmeier, D., Ruff, C. C., & Tobler, P. N. (2016). Cognitive biases associated with medical decisions: a systematic review. BMC medical informatics and decision making, 16(1), 138. https://doi.org/10.1186/s12911-016-0377-1

Appendix

PICOT Question Template
Section 1: In this section provide one word to describe each section of your proposed PICOT question.
P		Population	Nursing Professionals
I		Intervention	Nurses’ training and education
C		Comparison	A lack of training
O		Outcome	Awareness of cognitive biases
T		Timeline	12 weeks
Section 2: Write your PICOT question below using the words listed above.
PICOT	Among nursing professionals, what is the effect of training and education on cognitive biases’ awareness compared with lack of training within 12 weeks?
Section 3: Use your PICOT to develop a formalized statement. Use the examples below to help formulate statement.
Among nursing professional (P), what is the effect of training and education(I) on cognitive biases (O) compared with lack of training(C) within 12 weeks(T)? Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)? For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)? Does __________ (I) influence ________ (O) in (subject) who have _______ (P) over ______ (T)?

Evidence-Based Research Project