Effectiveness of a ‘do not interrupt’ vest intervention to reduce medication errors during medication administration: a multicenter cluster randomized controlled trial

Abstract

Background The use of a ‘do not interrupt’ vest during medication administration rounds is recommended but there have been no controlled randomized studies to evaluate its impact on reducing administration errors. We aimed to evaluate the impact of wearing such a vest on reducing such errors. The secondary objectives were to evaluate the types and potential clinical impact of errors, the association between errors and several risk factors (such as interruptions), and nurses’ experiences. Methods This was a multicenter, cluster, controlled, randomized study (March–July 2017) in 29 adult units (4 hospitals). Data were collected by direct observation by trained observers. All nurses from selected units were informed. A ‘Do not interrupt’ vest was implemented in all units of the experimental group. A poster was placed at the entrance of these units to inform patients and relatives. The main outcome was the administration error rate (number of Opportunities for Error (OE), calculated as one or more errors divided by the Total Opportunities for Error (TOE) and multiplied by 100). Results We enrolled 178 nurses and 1346 patients during 383 medication rounds in 14 units in the experimental group and 15 units in the control group. During the intervention period, the administration error rates were 7.09% (188 OE with at least one error/2653 TOE) for the experimental group and 6.23% (210 OE with at least one error/3373 TOE) for the control group (p = 0.192). Identified risk factors (patient age, nurses’ experience, nurses’ workload, unit exposition, and interruption) were not associated with the error rate. The main error type observed for both groups was wrong dosage-form. Most errors had no clinical impact for the patient and the interruption rates were 15.04% for the experimental group and 20.75% for the control group. Conclusions The intervention vest had no impact on medication administration error or interruption rates. Further studies need to be performed taking into consideration the limitations of our study and other risk factors associated with other interventions, such as nurse’s training and/or a barcode system. Trial registration The PERMIS study protocol (V2–1, 11/04/2017) was approved by institutional review boards and ethics committees (CPP Ile de France number 2016-A00211–50, CNIL 21/03/2017, CCTIRS 11/04/2016). It is registered at ClinicalTrials.gov (registration number: NCT03062852, date of first registration: 23/02/2017).

Medication administration errors and associated factors among nurses in Addis Ababa federal hospitals, Ethiopia: a hospital-based cross-sectional study

“…The odds of medication administration errors were higher among nurses who faced interruptions during medication administration compared with nurses who did not face interruptions, which is in agreement with findings of other studies. [42][43][44] Studies revealed that work interruptions during medication administration rounds are thought to be a prominent factor in medication errors that account for up to 43% of medication errors. 43 45 Nurses must remain attentive and focused when performing activities that require concentration to avoid distractions and errors.…”

Bibliometric analysis of core competencies associated nursing management publications

“…Solberg et al (2021) also cited Brady et al's (2009) study and used a cross‐sectional study investigation of drug modification. Furthermore, based on Brady et al's (2009) study, Berdot et al (2021) used a multicentre cluster randomized controlled trial to investigate reducing medication errors during medication administration. Speare et al (2021) then followed the study of Berdot et al (2021) to explore medication errors and medication administration related to nursing competence.…”

“…Furthermore, based on Brady et al's (2009) study, Berdot et al (2021) used a multicentre cluster randomized controlled trial to investigate reducing medication errors during medication administration. Speare et al (2021) then followed the study of Berdot et al (2021) to explore medication errors and medication administration related to nursing competence. These papers can be used as a reference for researchers to track or attempt studies in the same direction.…”

Shared Control in Human Robot Teaming: Toward Context-Aware Communication

“…In some interruption-prone environments, people have tried a variety of methods to reduce interruptions. For instance, in hospitals, people tried designating "interruptionfree" zones or using "do not interrupt" jackets [3,5]. However, it is unclear whether such methods will be feasible or effective long term [8].…”