Multitasking in postanesthesia care unit following nurse interruptions, an analysis of the causes and consequences using classification tree: an observational prospective study

Vacheron, Charles-Hervé; Peyrouset, Olivier; Incagnoli, Pascal; Charra, Virginie; Parat, S.; David, Jean-Stéphane; Theissen, A.; Piriou, Vincent; Friggeri, Arnaud

doi:10.1016/j.bjane.2021.05.013

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…The turnover of patients in oral PACU is generally 1.5-2 h and the patient’s condition change rapidly, which requires higher nursing quality. In the nursing process, there are differences between anesthesia nursing and routine disease nursing [ 14 ]. As one member mentioned: Because each patient has different characteristics, for example, patients with parotid gland, orthognathic jaw or malignant tumors.…”

Section: Discussionmentioning

confidence: 99%

The construction of patient quality management model in oral post anesthesia care unit in China: a grounded theory approach

et al. 2023

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Background Nowadays, people have paid more and more attention to the quality of physical and mental health recovery after oral surgery anesthesia. As a remarkable feature of patient quality management, it can effectively reduce the risk of postoperative complications and pain in Post Anesthesia Care Unit (PACU). However, the patient management model in oral PACU remains unknown, especially in China. The purpose of this study is to explore the management elements of patient quality management in the oral PACU and to construct the management model. Methods Strauss and Corbin’s grounded theory method was used to explore the experiences of three anesthesiologists, six anesthesia nurses and three administrators working in oral PACU. Twelve semi-structured interviews were conducted using face-to-face in a tertiary stomatological hospital from March to June, 2022. The interviews were transcribed and thematically analysed according to QSR NVivo 12.0 qualitative analysis tool. Results Three themes and ten subthemes were identified through an active analysis process, including three of the core team members: stomatological anesthesiologists, stomatological anesthesia nurses and administrators, three of the main functions: education and training, patient care and quality control and four of the team operation processes: analysis, plan, do, check. Conclusion The patient quality management model of the oral PACU is helpful for the professional identity and career development of stomatological anesthesia staff in China, which can accelerate the professional development of oral anesthesia nursing quality. According to the model, the patient’s pain and fear will decrease, meanwhile, safety and comfort will increase. It can make contributions to the theoretical research and clinical practice in the future.

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Section: Discussionmentioning

confidence: 99%

The construction of patient quality management model in oral post anesthesia care unit in China: a grounded theory approach

et al. 2023

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“…As the path analysis model indicates a linkage from concurrent multitasking and task switching to task time, the incidence and duration of the interruption seems to be one of the major causes for mental workload. This could be explained by the fact that when the nurses are interrupted in their task, their attention is shifted from the initial process to the new process with a decay of the memory of the initial process; this leads to an increase in response time when returning to the initial task or even the nurse starting the initial task over and hence a likelihood of overwhelmed cognitive capacities [14] and decreased productivity and accuracy in the EHR task [45,46].…”

Section: Interruption In Ehr Tasks and Its Relationship With Mental W...mentioning

confidence: 99%

“…The hypothetical framework in this study involved several interrelated factors according to the cognitive load framework in researches concluded by Jahns [13], including the inputs (mainly the source of interruption), the behaviour alteration (including task switching and concurrent multitasking), and the outputs (including mental workload and task error). Based on prior research [4,14], we classified nurses' reactions to workflow interruptions as task switching or concurrent multitasking. Task switching is defined as the response when ongoing tasks are interrupted by an unexpected event with the consequence of discontinuation of the primary task or task switching from this primary task; on the other hand, concurrent multitasking is defined as the simultaneous performance of the new task and the primary task, and it could turn into task switching when there are limitations on cognitive resources or on the time the task should be completed.…”

Section: Introductionmentioning

confidence: 99%

Workflow interruption and nurses’ mental workload in electronic health record tasks: An observational study

Shan

Shang²,

Yan³

et al. 2023

BMC Nurs

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Background Workflow interruptions are common in modern work systems. Electronic health record (EHR) tasks are typical tasks involving human–machine interactions in nursing care, but few studies have examined interruptions and nurses’ mental workload in the tasks. Therefore, this study aims to investigate how frequent interruptions and multilevel factors affect nurses’ mental workload and performance in EHR tasks. Methods A prospective observational study was conducted in a tertiary hospital providing specialist and sub-specialist care from June 1st to October 31st, 2021. An observer documented nurses’ EHR task interruptions, reactions and performance (errors and near errors) during one-shift observation sessions. Questionnaires were administered at the end of the electronic health record task observation to measure nurses’ mental workload for the electronic health record tasks, task difficulty, system usability, professional experience, professional competency, and self-efficacy. Path analysis was used to test a hypothetical model. Results In 145 shift observations, 2871 interruptions occurred, and the mean task duration was 84.69 (SD 56.68) minutes per shift. The incidence of error or near error was 158, while 68.35% of errors were self-corrected. The total mean mental workload level was 44.57 (SD 14.08). A path analysis model with adequate fit indices is presented. There was a relationship among concurrent multitasking, task switching and task time. Task time, task difficulty and system usability had direct effects on mental workload. Task performance was influenced by mental workload and professional title. Negative affect mediated the path from task performance to mental workload. Conclusions Nursing interruptions occur frequently in EHR tasks, come from different sources and may lead to elevated mental workload and negative outcomes. By exploring the variables related to mental workload and performance, we offer a new perspective on quality improvement strategies. Reducing harmful interruptions to decrease task time can avoid negative outcomes. Training nurses to cope with interruptions and improve competency in EHR implementation and task operation has the potential to decrease nurses’ mental workload and improve task performance. Moreover, improving system usability is beneficial to nurses to mitigate mental workload.

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“…Another issue regarding high complexity is related to the size of nurse and anesthesia teams, as larger teams present high fixed costs and variable demand results in lower profitability. Optimizing the tasks of Postoperative Care Unit nurses, for example, could reduce the risk of clinical complications, nurse burnout, and improve efficiency, as suggested by Vacheron et al 2 This interesting study employs an artificial intelligence model (C 5.0) to select the primary predictors of the type of multitask performed. Leaders can directly apply the study's results and indirectly adopt the same methodology to analyze internal data, thereby learning from this exemplary approach.…”

Section: Operating Room Managementmentioning

confidence: 99%

Anesthesia services management, economics, and new technologies

Guimarães¹,

Bogniotti²,

Alecrim³

et al. 2023

Brazilian Journal of Anesthesiology (English Edition)

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Multitasking in postanesthesia care unit following nurse interruptions, an analysis of the causes and consequences using classification tree: an observational prospective study

Cited by 3 publications

References 21 publications

The construction of patient quality management model in oral post anesthesia care unit in China: a grounded theory approach

The construction of patient quality management model in oral post anesthesia care unit in China: a grounded theory approach

Workflow interruption and nurses’ mental workload in electronic health record tasks: An observational study

Anesthesia services management, economics, and new technologies

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