Maree Johnson1,2, Paula Sanchez3, Rachel Langdon4, Elizabeth Manias5,6, Tracy Levett-Jones7, Gabrielle Weidemann8, Vicki Aguilar9, Bronwyn Everett3,2. 1. Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia. 2. Ingham Institute of Applied Medical Research, Sydney, NSW, Australia. 3. School of Nursing and Midwifery, Western Sydney University, Sydney, NSW, Australia. 4. Centre for Applied Nursing Research, Ingham Institute of Applied Medical Research, Sydney, NSW, Australia. 5. Deakin University, Burwood, Victoria, Australia. 6. University of Melbourne, Burwood, Victoria, Australia. 7. University of Newcastle, Callaghan, NSW, Australia. 8. School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia. 9. South Western Sydney Local Health District (SWSLHD) Centre for Education and Workforce Development, Liverpool, New South Wales, Australia.
Abstract
AIM: To explore interruptions during medication preparation and administration and their consequences. BACKGROUND: Although not all interruptions in nursing have a negative impact, interruptions during medication rounds have been associated with medication errors. METHOD: A non-participant observational study was undertaken of nurses conducting medication rounds. RESULTS: Fifty-six medication events (including 101 interruptions) were observed. Most medication events (99%) were interrupted, resulting in nurses stopping medication preparation or administration to address the interruption (mean 2.5 minutes). The mean number of interruptions was 1.79 (SD 1.04). Thirty-four percent of medication events had at least one procedural failure, while 3.6% resulted in a clinical error. CONCLUSIONS: Our study confirmed that interruptions occur frequently during medication preparation and administration, and these interruptions were associated with procedural failures and clinical errors. Nurses were the primary source of interruptions with interruptions often being unrelated to patient care. IMPLICATIONS FOR NURSING MANAGEMENT: This study has confirmed that interruptions are frequent and result in clinical errors and procedural failures, compromising patient safety. These interruptions contribute a substantial additional workload to medication tasks. Various interventions should be implemented to reduce non-patient-related interruptions. Medication systems and procedures are advocated, that reduce the need for joint double-checking of medications, indirectly avoiding interruptions.
AIM: To explore interruptions during medication preparation and administration and their consequences. BACKGROUND: Although not all interruptions in nursing have a negative impact, interruptions during medication rounds have been associated with medication errors. METHOD: A non-participant observational study was undertaken of nurses conducting medication rounds. RESULTS: Fifty-six medication events (including 101 interruptions) were observed. Most medication events (99%) were interrupted, resulting in nurses stopping medication preparation or administration to address the interruption (mean 2.5 minutes). The mean number of interruptions was 1.79 (SD 1.04). Thirty-four percent of medication events had at least one procedural failure, while 3.6% resulted in a clinical error. CONCLUSIONS: Our study confirmed that interruptions occur frequently during medication preparation and administration, and these interruptions were associated with procedural failures and clinical errors. Nurses were the primary source of interruptions with interruptions often being unrelated to patient care. IMPLICATIONS FOR NURSING MANAGEMENT: This study has confirmed that interruptions are frequent and result in clinical errors and procedural failures, compromising patient safety. These interruptions contribute a substantial additional workload to medication tasks. Various interventions should be implemented to reduce non-patient-related interruptions. Medication systems and procedures are advocated, that reduce the need for joint double-checking of medications, indirectly avoiding interruptions.
Authors: Kimberly D Johnson; Christopher J Lindsell; Craig Froehle; Gordon Lee Gillespie Journal: Int J Qual Health Care Date: 2021-11-20 Impact factor: 2.038
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