Distractions and Interruptions in the Intensive Care Unit: A Field Observation and a Simulator Experiment

Abstract

Distractions and interruptions are frequently mentioned as sources of errors in healthcare research, and laboratory research has shown that they can disrupt cognition. However, the current evidence that distractions and interruptions cause patient harm is mixed. In two studies in an intensive care unit, we investigated whether and when distractions and interruptions might lead nurses to forget critical care tasks. Study 1 was an observational study using a mobile eye tracker. It investigated which properties of an interruption influence resumption times and how nurses manage distractions and interruptions. Study 2 was a controlled experiment in a full-scale patient simulator. It investigated whether reminders improve nurses' ability to remember routine tasks when multitasking and resume interrupted routine tasks. We discuss theoretical and practical implications of the studies.

Interruption management in the intensive care unit: Predicting resumption times and assessing distributed support.

“…A preliminary analysis on data from four nurses was published in a conference proceedings (Grundgeiger, Sanderson, MacDougall, & Venkatesh, 2009b) and the distribution of memory demands was published in a conference proceedings (Grundgeiger, Sanderson, MacDougall, & Venkatesh, 2009a). In addition, a high level summary of the study has been reported in a further conference proceedings (Grundgeiger et al, 2010).Correspondence concerning this article should be addressed to Tobias Grundgeiger, Institute for Experimental Psychology, Heinrich-Heine-Universität, D-40225, Düsseldorf. E-mail: tobias.grundgeiger@uni-duesseldorf.de Journal of Experimental Psychology: Applied © 2010 American Psychological Association 2010 1076-898X/10/$12.00 DOI: 10.1037/a0021912 317 tive memory studies to explain why some anesthesiologists forgot a task.…”

“…A preliminary analysis on data from four nurses was published in a conference proceedings (Grundgeiger, Sanderson, MacDougall, & Venkatesh, 2009b) and the distribution of memory demands was published in a conference proceedings (Grundgeiger, Sanderson, MacDougall, & Venkatesh, 2009a). In addition, a high level summary of the study has been reported in a further conference proceedings (Grundgeiger et al, 2010).…”

Defibrillation safety: an examination of paramedic perceptions using eye-tracking technology

“…Only 46% of students in the study had previous experience using the AED which may have increased uncertainty and stress. Another study using eye-tracking technology in nurses found that distraction led to current tasks being incomplete or missed all together 20. Distractions in simulation two in particular, could have led to students forgetting to verbalise and visualise appropriately.…”

“…The technology has also been used in scooter riding simulations to measure hazard perception 19. One recent study related to healthcare utilised the glasses to examine distractions in nurses 20. The eye-tracking technology captured the nurses fixation on distractions and interruptions which enabled the researchers to see if it was affecting the nurses current task 20.…”

“…One recent study related to healthcare utilised the glasses to examine distractions in nurses 20. The eye-tracking technology captured the nurses fixation on distractions and interruptions which enabled the researchers to see if it was affecting the nurses current task 20. Another study used eye-tracking glasses during simulation of patient medication administration to analyse if nurses were accurately reading patient charts and identification bands to minimise drug administration errors 21…”