Literature DB >> 25326118

Effects of the no interruption zone on distraction levels, withdrawal times, and adenoma detection rates of colonoscopy.

Nancy S Behazin1, Michelle Thompson, Mena Milad, Jeffrey Hart, Juhee Song, Mark Jeffries, Dawn M Sears.   

Abstract

BACKGROUND: The creation of no interruption zones (NIZs) reduces medical errors by reducing distraction levels on hospital wards. To date, the effect of a NIZ during colonoscopy has not been evaluated. AIMS: Assess the effects of a NIZ during colonoscopy, on distraction levels, withdrawal times, and adenoma detection rates (ADRs).
METHODS: This was a non-randomized prospective study of screening colonoscopies at a teaching hospital. The intervention, a NIZ, was created by limiting conversations to the care of the patient undergoing the procedure and posting a "do not disturb" sign during the withdrawal phase of colonoscopy. Distraction levels, withdrawal times, and ADRs were analyzed at baseline and after the NIZ.
RESULTS: The implementation of the NIZ leads to a significant reduction of high-distraction-level environments (13.1 vs. 5.1 %; p < 0.0001). There was a significant decrease in withdrawal time with NIZs; (10.6 vs. 9.9 min, p = 0.0038). There was no significant difference in ADRs (38 % baseline vs. 36 % NIZs, respectively; p = 0.33).
CONCLUSIONS: Creation of a NIZ was associated with a significant decrease in high-distraction environments and shorter withdrawal times with no significant change in ADRs. Further studies are needed to evaluate whether lower distraction levels in an endoscopy suite translate to improved quality measures.

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Mesh:

Year:  2014        PMID: 25326118     DOI: 10.1007/s10620-014-3396-8

Source DB:  PubMed          Journal:  Dig Dis Sci        ISSN: 0163-2116            Impact factor:   3.199


  18 in total

1.  The science of interruption.

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Journal:  BMJ Qual Saf       Date:  2012-03-15       Impact factor: 7.035

Review 2.  Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer.

Authors:  David A Lieberman; Douglas K Rex; Sidney J Winawer; Francis M Giardiello; David A Johnson; Theodore R Levin
Journal:  Gastroenterology       Date:  2012-07-03       Impact factor: 22.682

3.  Association of interruptions with an increased risk and severity of medication administration errors.

Authors:  Johanna I Westbrook; Amanda Woods; Marilyn I Rob; William T M Dunsmuir; Richard O Day
Journal:  Arch Intern Med       Date:  2010-04-26

4.  Quality indicators for colonoscopy.

Authors:  Douglas K Rex; John L Petrini; Todd H Baron; Amitabh Chak; Jonathan Cohen; Stephen E Deal; Brenda Hoffman; Brian C Jacobson; Klaus Mergener; Bret T Petersen; Michael A Safdi; Douglas O Faigel; Irving M Pike
Journal:  Am J Gastroenterol       Date:  2006-04       Impact factor: 10.864

5.  Is the "sterile cockpit" concept applicable to cardiovascular surgery critical intervals or critical events? The impact of protocol-driven communication during cardiopulmonary bypass.

Authors:  Rishi K Wadhera; Sarah Henrickson Parker; Harold M Burkhart; Kevin L Greason; James R Neal; Katherine M Levenick; Douglas A Wiegmann; Thoralf M Sundt
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6.  Critical phase distractions in anaesthesia and the sterile cockpit concept.

Authors:  M A Broom; A L Capek; P Carachi; M A Akeroyd; G Hilditch
Journal:  Anaesthesia       Date:  2011-03       Impact factor: 6.955

7.  Effect of simply recording colonoscopy withdrawal time on polyp and adenoma detection rates.

Authors:  Andrew Taber; Joseph Romagnuolo
Journal:  Gastrointest Endosc       Date:  2010-04       Impact factor: 9.427

8.  Quality indicators for colonoscopy and the risk of interval cancer.

Authors:  Michal F Kaminski; Jaroslaw Regula; Ewa Kraszewska; Marcin Polkowski; Urszula Wojciechowska; Joanna Didkowska; Maria Zwierko; Maciej Rupinski; Marek P Nowacki; Eugeniusz Butruk
Journal:  N Engl J Med       Date:  2010-05-13       Impact factor: 91.245

9.  Effect of institution-wide policy of colonoscopy withdrawal time > or = 7 minutes on polyp detection.

Authors:  Mandeep S Sawhney; Marcelo S Cury; Naama Neeman; Long H Ngo; Janet M Lewis; Ram Chuttani; Douglas K Pleskow; Mark D Aronson
Journal:  Gastroenterology       Date:  2008-08-27       Impact factor: 22.682

10.  Variation in colonoscopic technique and adenoma detection rates at an academic gastroenterology unit.

Authors:  Mark E Benson; Mark Reichelderfer; Adnan Said; Eric A Gaumnitz; Patrick R Pfau
Journal:  Dig Dis Sci       Date:  2009-01-21       Impact factor: 3.199

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