Interruptions and Pediatric Patient Safety

Hall, Linda M.; Pedersen, Cheryl; Hubley, Pam; Ptack, Elana; Hemingway, Aislinn; Watson, Carolyn; Keatings, Margaret

doi:10.1016/j.pedn.2008.09.005

Cited by 73 publications

(74 citation statements)

References 13 publications

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“…The most common sources/causal factors of interruptions during medication administration included the environment, caregivers, physicians, other staff nurses, and communication issues. Study findings were consistent with previous research, with a third of interruptions experienced by nurses attributing to the work environment (McGillis Hall et al, ). Different from previous research (Kosits, & Jones, ), this study found that patients’ caregivers were more likely to interrupt nurses during medication administration.…”

Section: Discussionsupporting

confidence: 92%

Interruptions experienced by nurses during pediatric medication administration in China: An observational study

Jun-wen

Qiaoling

Wang

et al. 2019

Specialist Pediatric Nursing

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Purpose The objectives of this study were to describe (a) the frequency of interruptions experienced by a pediatric nurse per hour, (b) the sources of interruptions experienced by a pediatric nurse, and (c) the interruption outcomes during pediatric medication administration. Design and Methods This design of this study was a cross‐sectional observational study. A convenience sample of pediatric nurses was used in this study. The interruption observation sheet was used to collect data about the frequency, sources, and outcomes of interruptions. Results There was a total of 43 nurses were observed in more than 180 medication administration rounds. An interruption rate of 94.51% occurred during pediatric medication administration. The frequency of interruptions was three or more times (51.04%). The most common source of interruption was attributed to the working environment (32.37%). The second most frequent reason for interruption came from personnel, such as caregivers (24.48%), followed by physicians (10.79%), and other nursing staff (9.54%). The third most common source of interruption was communication issues, including patient interviews, patient reports, and case discussion (8.71%). Six errors (2.49%) were reported out of 241 interruptions as a result of interruptions. In specific, causes of errors during pediatric medication administration were due to wrong medication dose. Practice Implications This study provides important information on interruptions experienced by pediatric nurses during medication administration in Chinese hospital settings and found that interruptions frequently occur in pediatric units.

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Section: Discussionsupporting

confidence: 92%

Interruptions experienced by nurses during pediatric medication administration in China: An observational study

Jun-wen

Qiaoling

Wang

et al. 2019

Specialist Pediatric Nursing

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“…An interruption may well occur, for example, due to an emerging problem. Indeed, in the study by McGillis Hall et al ,17 a positive outcome was reported in 11% of the interruptions. In these situations, paediatric nurses give priority to the most relevant task, an issue that in the paediatric setting implies a ‘family-centred’ approach.…”

Section: Discussionmentioning

confidence: 90%

“…The findings should be applied mainly to a paediatric population, although no striking difference with other adult settings was found. Only McGillis Hall et al 17 had previously explored the paediatric setting. They found that 9.3% of the interruptions during nursing care occurred during medications, but no improvement programme was described.…”

Section: Discussionmentioning

confidence: 99%

“…These findings have also been confirmed in paediatric settings. For instance, McGillis Hall et al 17 showed that factors in the work environment itself accounted for one-third (32.7%) of the interruptions. The results of a survey on medication administration practices revealed that 86% of the children's nurses considered interruptions as a cause of medication errors 6…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of an improvement programme to prevent interruptions during medication administration in a paediatric hospital: a preintervention–postintervention study

et al. 2017

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ObjectiveTo assess the effectiveness of an improvement programme to reduce the number of interruptions during the medication administration process in a paediatric hospital.Design and methodsA prestudy–post study design was used to monitor nursing interruptions during medication cycles in a paediatric hospital. Interruptions were reported on an observation sheet (MADOS-P) adapted to the paediatric context.SettingA 600-bed tertiary paediatric research hospital in Italy.InterventionThe interventions included a yellow sash worn by nurses during medication cycles, a yellow-taped floor area indicating the ‘No interruption area’, visual notices in the medication areas, education sessions for healthcare providers and families, patient and parent information material.Results225 medication cycles were observed before the intervention (T0) and 261 after the intervention (T1). The median of interruptions occurring in each cycle decreased significantly from baseline to postintervention (8.0 vs 2.0, p=0.002), as the rate ratios (interruptions/patient post–pre ratio: 0.34; interruptions/medication post–pre ratio: 0.37; interruptions/hour of medication cycle post–pre ratio: 0.53, p<0.001). During preintervention, the main causes of interruptions were ‘other patients’ (19.9%), ‘other nurses’ (17.2%) and ‘conversation’ (15.7%); during postintervention, they were ‘other nurses’ (26.1%), ‘conversation’ (18.2%) and ‘other patients’ (17.4%).ConclusionsThis bundle of interventions proved to be an effective improvement programme to prevent interruptions during medication administration in a paediatric context.

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“…Furthermore, the medical literature is very clear that interruptions lead to operational failures, reduced provider effectiveness, and increased risk to patient safety. [17][18][19] The current system, as described in this study, and the perceptions by other staff are not always conducive to recognizing and supporting both CP roles equally. In a recent article, Patterson et al 3 studied other providers' perceptions of pharmacist integration in VA PACT teams.…”

Section: Discussionmentioning

confidence: 82%