Characteristics of distractions in the intensive care unit: how serious are they and who are at risk?

See, Kay Choong; Phua, Jason; Mukhopadhyay, Amartya; Lim, Tow Keang

doi:10.11622/smedj.2014086

Cited by 12 publications

(8 citation statements)

References 19 publications

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“…10,11,46,47 Distractions occur frequently in the ICU from multiple sources including telephone calls, monitor alarms, pagers, other health care providers' requests, patients, and patients' families. 48 An observational study in ICUs showed that ICU physicians get interrupted 3.8 times per hour (once every 15.8 minutes on average), whereas compa-rable physicians on hospital wards experience 2.9 interruptions per hour. 49,50 These interruptions may distract providers who are involved in handoffs, and prevent them from listening actively and engaging in discussion.…”

Section: The Physical Settingmentioning

confidence: 99%

Improving the Patient Handoff Process in the Intensive Care Unit: Keys to Reducing Errors and Improving Outcomes

Colvin

Eisen

Gong

2016

Semin Respir Crit Care Med

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Patient handoffs are highly variable and error prone. They have been recognized as a major health care challenge. Patients in the intensive care unit are particularly vulnerable due to their complex clinical history and the critical nature of their condition. Given a general movement from traditional long call to shift schedules, the number of patient handoffs will likely continue to increase. Optimization of the handoff process has become even more critical to ensure patient safety. In this review, we reflect on the importance of the handoff process, review common errors, identify barriers and challenges, and propose different methods to improving the handoff process. The purpose of this article is to examine the overall scope of the problem; provide the most up-to-date evidence on the handoff process; and identify ways to perform handoffs in an accurate, safe, and efficient manner to provide high-quality patient care. The direction of future research is also proposed.

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Section: The Physical Settingmentioning

confidence: 99%

Improving the Patient Handoff Process in the Intensive Care Unit: Keys to Reducing Errors and Improving Outcomes

Colvin

Eisen

Gong

2016

Semin Respir Crit Care Med

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“…This is due to the fast pace of ICU work and the complex condition of patients, which requires multidisciplinary collaboration, leading to more frequent interruption events for ICU nurses. 10 , 11 Due to the complexity of patients’ conditions, intensive use of high-risk drugs with various instruments and equipment, frequent treatment of patients and close working units, nursing staff in the ICU are particularly vulnerable to interference and interruption. 11 Therefore, relatively speaking, ICU nursing document writing interruption events occur more frequently.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing the Interruption of Nursing Document Writing in the Intensive Care Unit: A Cross-Sectional Survey

Ma¹,

Bai²,

Xie³

et al. 2023

JMDH

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Objective To explore the current status of interruption events in nursing document writing in the intensive care unit (ICU) using a cross-sectional survey. Methods Between May and October 2021, the convenience sampling method was used to observe the interruption events in nursing document writing in the ICU. A total of 54 nurses and 7 indicators were observed: the start time, end time, interruption period, source, type, duration and outcome of interruption events. Results A total of 438 interruption events in nursing document writing occurred in 85.955 hours, with a frequency of 5.093 times/hour and a duration of 4787.00 (1152.00, 13,109.00) seconds. The frequency of interruption events in nursing document writing was the highest (11 times/hour) and the duration was the longest (9581.50 seconds) from 08:00 to 12:00. The main sources of interruptions for nurses with 10 or more years of service or with the professional title of nurse are nurses themselves and their colleagues. The main sources of interruptions for nurses who have been in charge for 10 years or over are the working environment and doctors. This intervention in work continuity occurs unexpectedly; however, if adjustments are made to nursing procedures, the interruption can be terminated rapidly or adverse consequences can be avoided. Years of working experience, seniority level, interruption time periods and professional titles were independent factors influencing the number of interruption events, and they were all positively correlated. The results of this study show that there were statistically significant differences in the incidence of negative outcomes among ICU nurses with varying years of working experience and professional titles. Conclusion Interruptions in nursing document writing have high frequency, complex sources and multiple types. For senior nurses, the outcome was predominantly positive, while for junior nurses, it was predominantly negative.

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“…Finally, we invited some outpatient department managers and outpatient physicians to discuss the connotation and signi cance of each task in the task list and summarize the category of work tasks. Table 1 presents 8 work tasks associated with doctor-patient communication tasks and non-doctor-patient communication tasks [8,9,40,41]. Inquire about the occurrence, development, current symptoms and treatment history of the disease from patients and their relatives.…”

Section: Identi Cation Of Work Tasks and Work Ow Interruptionsmentioning

confidence: 99%

An Observational Study of Physicians' Workflow Interruptions in Outpatient Departments in China

Zhu

Wang

et al. 2021

Preprint

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Background: Workflow interruptions are frequent in hospital outpatient clinics. Eventually, not only reducing the work efficiency and quality, but also further threatening patient safety. Over the last 10–15 years, research on workflow interruptions in inpatient care has increased, but there is a lack of research on the interruptions in outpatient clinics. The present study aimed to study the differences in physicians' workflow interruptions among outpatient departments in the tertiary hospital in China.Methods: In a tertiary hospital, a standardized observational study of 32 doctors' workflow in outpatient department of four typical clinical specialties was conducted. The record of workflow interruptions was based on a self-made observation instrument after verifying its reliability and validity. Linear regression methods were used to assess outpatient characteristics as predictors of the number of interruptions. The Kruskal-Wallis test was used to analyze the difference about the duration of interruptions among specialties, and the Chi-Square Test was used to examine the sources of interruptions among different specialties, to determine whether interruption source is associated with specialty.Results: The number of patients was the significant independent predictor of the number of interruptions(p<0.001). In terms of work tasks being interrupted, the highest interruption rate occurred when physicians were asking health history: 19.95 interruptions per hour. The distribution of interruption sources among the four clinical specialties were statistically different (Χ2 =16.988, p = 0.049). Conclusion: The findings indicate that physicians' workflow interruptions are connected with many contents in the work system. Further emphasis should be placed on the effective application of hospital management measures in an interrupted environment to promote a safe and efficiency outpatient care.

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Characteristics of distractions in the intensive care unit: how serious are they and who are at risk?

Cited by 12 publications

References 19 publications

Improving the Patient Handoff Process in the Intensive Care Unit: Keys to Reducing Errors and Improving Outcomes

Improving the Patient Handoff Process in the Intensive Care Unit: Keys to Reducing Errors and Improving Outcomes

Factors Influencing the Interruption of Nursing Document Writing in the Intensive Care Unit: A Cross-Sectional Survey

An Observational Study of Physicians' Workflow Interruptions in Outpatient Departments in China

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