Environmental elements affecting the decision‐making process in nursing practice

Hedberg, Berith; Larsson, Ullabeth Sätterlund

doi:10.1046/j.1365-2702.2003.00879.x

Cited by 75 publications

(89 citation statements)

References 27 publications

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“…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. need for culture change to limit avoidable interruptions, especially during complex or high-risk activities such as medication administration.…”

Section: Review Of the Literaturesupporting

confidence: 65%

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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Section: Review Of the Literaturesupporting

confidence: 65%

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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“…Thus, one might question whether employers look for both competence and an ability to adapt to one's work environment when hiring nurses. The findings of this study indicate that nurses try to avoid conflicts (Duddle and Boughton 2007) and follow the desires of co-workers (Hedberg and Sätterlund Larsson 2004). Yet the nurses interviewed here seem to adapt to various working conditions while remaining conscious of when they need to learn and how they learn from others.…”

Section: Nurses Work As a Learning Environmentmentioning

confidence: 73%

“…Within the hospital environment, autonomy and control over nursing care delivery have positive influences on nurses' interprofessional relationships (Budge et al 2003). Nevertheless, nurses show consideration for other members of the work community as they try to avoid conflicts (Duddle and Boughton 2007) and interrupt their activities to address the desires from other team members (Hedberg and Sätterlund Larsson 2004). Hence, a social environment should not only provide opportunities to learn, but should also enable nurses to engage in complex activities and relationships in their work.…”

Section: Introductionmentioning

confidence: 99%

How Nurses Experience Their Work as a Learning Environment

Skår

2009

Vocations and Learning

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This article explores and illuminates the meaning of nurses' experiences with their work as a learning environment. A qualitative hermeneutic approach guided the research process and the analysis and interpretation of the transcribed interview-texts of eleven graduate nurses. Three core themes emerged from these informants' descriptions of their work as a learning environment: 'participation in the work community', 'to engage in interpersonal relations' and 'accessing important knowledge resources'. The study found that, for these informants, an understanding of work as a learning environment is connected to how the nurses elect to engage in their workplaces and how the workplaces regulate their participation in activities and interpersonal relations. The nurses were aware of their responsibilities for continuous learning at work, and to confirm, create and develop their practical and professional knowledge, they obtained support from knowledgeable co-workers and chose among accessible knowledge resources in their particular workplaces. Concurrently, workplace characteristics such as the community of workers, hierarchical structures, cultural practices, and personal relations influenced learning. This understanding of the learning environment in particular workplaces shows the importance of focusing on learning processes as part of professional development in an ever-changing health care system.

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“…When their children's care management problems came into question, mothers interrupted the medication preparation and administration processes of nurses. While patient-caused interruption was placed on the top in the study of Palese et al (4), it was reported to cause interruptions by 24.7% in the study of Hedberg and Larsson (17). These interruptions were unpredictable and unanticipated.…”

Section: Discussionmentioning

confidence: 99%