Characteristics of Work Interruptions During Medication Administration

Biron, Alain; Lavoie-Tremblay, MÃ©lanie; Loiselle, Carmen G.

doi:10.1111/j.1547-5069.2009.01300.x

Cited by 105 publications

(124 citation statements)

References 23 publications

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“…These interruptions are significant because of adverse events noted in the literature regarding the adverse effects of interruptions on efficiency and error. [11][12][13][14] Task reacquisition times within this context have had limited prior exploration in one study, 1 which utilized dedicated observers. Our study examined behaviors among existing members of the clinical team and was not resourced to capture these data.…”

Section: Discussionmentioning

confidence: 99%

Nature and Impact of Interruptions on Clinical Workflow of Medical Residents in the Inpatient Setting

Ly¹,

Korb-Wells²,

Sumpton³

et al. 2013

Journal of Graduate Medical Education

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Background Medical officers (trainees) in their first to third postgraduate years (PGY-1–3s) work in complex, busy environments, performing tasks that require concentration and application of learned skills. There are frequently competing demands, and being paged is among the most common. Objective We quantified and described the effect of interruptions that paging created on the clinical workflow of PGY-1–3s during ward duties. Methods This prospective study was conducted at 2 teaching hospitals in Sydney, Australia. Medical students were recruited as observers to log interruptions of PGY-1–3s' workflow arising from pages from other members of the hospital team. Results Forty-two pairs consisting of a PGY-1–3 trainee and an observer were recruited, with 24 proceeding to data collection. Nursing was the most frequent source of pages (47%); other medical staff accounted for 16% of pages, allied health for 12%, and others for 24% (with pharmacy the most common). Pages commonly involved direct patient care (46%), followed by medication issues (21%). Tasks interrupted by pages encompassed direct patient care (37%), indirect patient care (15%), and documentation (12%). Only 27% of pages were assessed as appropriate and urgent, while 58% were considered appropriate but not urgent, and 16% were not appropriate. Only 38% of pages were judged to be clinically more important than the task they interrupted. Conclusions Pages frequently interrupted direct patient care activities for PGY-1–3 trainees, and a significant proportion of pages were identified as either not requiring immediate attention or not appropriate, resulting in potentially avoidable interruptions to clinical workflow. Alternate means of alerting trainees to nonurgent tasks may reduce interruptions and facilitate patient care.

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Section: Discussionmentioning

confidence: 99%

Nature and Impact of Interruptions on Clinical Workflow of Medical Residents in the Inpatient Setting

Ly¹,

Korb-Wells²,

Sumpton³

et al. 2013

Journal of Graduate Medical Education

View full text Add to dashboard Cite

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“…Manually collected data were entered into a database (MS Access, Microsoft, Seattle, Washington) and were analyzed using SPSS 15.0 (IBM, Armonk, New Mean hourly rates of stimuli observed in this study were higher than those reported in similar studies in other health care settings. 1,[8][9][10][11][12][13] In one study of pharmacy practice, pharmacists and pharmacy technicians were exposed to 6 interruptions per hour, while physicians and nurses were each exposed to 4 to 10 interruptions per hour. 1 An analysis of 4 stimuli related to the corrective measures implemented in 2011 highlighted significant reductions in certain stimuli for certain groups of pharmacy professionals.…”

Section: Discussionmentioning

confidence: 99%

Before-and-After Study of Interruptions in a Pharmacy Department

Guérin

Caron

Lebel

et al. 2013

CJHP

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“…[4][5][6][7][8] The work environment is error-prone, especially during complex or high-risk activities, because interruptions and multitasking behaviors create conditions affecting working memory and attention resources. 9,10 Nurses' cognitive processes during medication administration are complex and require a high degree of critical thinking and vigilance to prevent patient harm.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…8,12 System failures such as missing medications and access to equipment and supplies were also identified as sources of interruptions that are potentially avoidable. 7,8,[12][13][14][15][16] Other avoidable interruptions cited in the literature are the tendency of nurses to interrupt each other with conversations unrelated to medication administration 7,[17][18][19] while preparing medications and to respond immediately to requests from others when interrupted. 7,15,20 These findings support the idea that interruptions are an accepted part of nursing practice and suggest the Attendance at the National Teaching Institute was the inspiration for this project and the springboard for addressing existing nursing concerns about interruptions.…”

Section: Review Of the Literaturementioning

confidence: 99%

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Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration

Flynn

Evanish

Fernald

et al. 2016

Critical Care Nurse

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BACKGROUND Because of the high frequency of interruptions during medication administration, the effectiveness of strategies to limit interruptions during medication administration has been evaluated in numerous quality improvement initiatives in an effort to reduce medication administration errors. OBJECTIVES To evaluate the effectiveness of evidence-based strategies to limit interruptions during scheduled, peak medication administration times in 3 progressive cardiac care units (PCCUs). A secondary aim of the project was to evaluate the impact of limiting interruptions on medication errors. METHODS The percentages of interruptions and medication errors before and after implementation of evidence-based strategies to limit interruptions were measured by using direct observations of nurses on 2 PCCUs. Nurses in a third PCCU served as a comparison group. RESULTS Interruptions (P < .001) and medication errors (P = .02) decreased significantly in 1 PCCU after implementation of evidence-based strategies to limit interruptions. Avoidable interruptions decreased 83% in PCCU1 and 53% in PCCU2 after implementation of the evidence-based strategies. CONCLUSIONS Implementation of evidence-based strategies to limit interruptions in PCCUs decreases avoidable interruptions and promotes patient safety. (Critical Care Nurse. 2016;36[4]:19-35) This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: 1. Describe similarities between the principles of the sterile cockpit concept used in the aviation industry and the Nurses Uninterrupted Passing Medications Safely (NUPASS) guidelines to promote safety 2. Discuss the current evidence supporting use of interruption limiting strategies to reduce medication administration errors in the acute care setting 3. Implement evidence-based strategies to limit interruptions during medication administration To complete evaluation for CE contact hour(s) for test #C1642, visit www.ccnonline.org and click the "CE Articles" button. No CE test fee for AACN members. This test expires on August 1, 2019.The American Association of Critical-Care Nurses is an accredited provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. AACN has been approved as a provider of continuing education in nursing by the State Boards of Registered Nursing of California (#01036) and Louisiana (#LSBN12). N urses play a critical role in promoting patient safety through surveillance and interception of errors that cause patient harm as hospitals and health care systems strive to become high-reliability organizations. APRN, MS, Advocate Christ Medical Center, 4400 W 95th St, Oak Lawn,.To purchase electronic or print reprints, contact the American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 899-1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, reprints@aacn.org. patient harm, and strategies to reduce interruptions and manage them appropriatel...

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Characteristics of Work Interruptions During Medication Administration

Abstract: Interventions to reduce WIs during the medication administration process should target nurses and system failures to maximize medication administration safety.

Cited by 105 publications

References 23 publications

Nature and Impact of Interruptions on Clinical Workflow of Medical Residents in the Inpatient Setting

Nature and Impact of Interruptions on Clinical Workflow of Medical Residents in the Inpatient Setting

Before-and-After Study of Interruptions in a Pharmacy Department

Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration

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