Effects of Interruptions on Prospective Memory Performance in Anesthesiology

Abstract

Interruptions have been associated with adverse events in healthcare. However, supporting studies are descriptive and atheoretical rather than explanatory, and they seldom show that interruptions compromise patient safety. Prospective memory may provide useful theoretical background. We analyzed video from a full-scale patient simulator for factors enhancing or inhibiting anesthesiologists' prospective memory performance. The critical task was to remember to cross check a unit of blood against the patient before administering the blood. All 12 participants were interrupted by the surgeon when the blood arrived. Only participants who self-initiated the retrieval (n = 3), or returned their full attention to the transfusion task and saw the blood bag label (n = 7), remembered the check. The result can be explained with findings from prospective memory literature.

Two sides to every story: The Dual Perspectives Method for examining interruptions in healthcare

“…Interruptions are counted and classified using predefined categories according to who and what is being interrupted, often with only limited use of participant narratives regarding the semantics of their work. With the emphasis on the individual clinician, theories of individual cognition, such as Prospective Memory or Memory for Goals, have been applied to understand the often detrimental effect that interruptions have (Brumby et al, 2013;Boehm-Davis and Remington, 2009;Nees and Fortna, 2015;Monk et al, 2008;Grundgeiger et al, 2008). Increasingly, researchers have adopted a systemsbased approach that views interruptions not as a single, onesided 'event' experienced by an individual, but as a process shaped by the demands of a sociotechnical system (Rivera, 2014;Werner and Holden, 2015).…”

Robot Classification of Human Interruptibility and a Study of Its Effects

“…[43], the loss in task performance is not as significant; a result predicted by the Goal-Activation model of interruption handling [2]. Similarly, in embodied settings, when people defer an incoming interruption, they are more likely to complete their original task [23]; a result predicted by Prospective Memory [38] models of interruption handling [24]. Recent results from HFE continue to show that performance loss is not noticeable with tasks that are embodied or skill-based, even when the interruptions might be computer mediated as in the work of Lee & Duffy [35] and Kolbeinsson et al [33].…”

“…In HCI and HFE, the cost of an interruption on-screen has been evaluated with quantitative metrics such as time on task [1,33,37,40], the number of tasks completed [40], the number of incomplete tasks [23], the number of errors [35,40], switching time [30,33,43], and workload [1,37]; and qualitative metrics such as respect [1] and preference [40]. In embodied settings, researchers have also used structured interviews [24,55,57] and ethnographies [18,24,45,55] to evaluate long-term interruption costs.…”

Prospective memory in the nursing environment: Effects of type of prospective task and prospective load

“…Given the heavy PM demands placed on nurses, as well as the grave consequences for forgetting, it is surprising to find only one study (which was observational in nature) that has examined PM in nursing (Grundgeiger, Sanderson, MacDougall, & Venkatesh, 2009), though two have examined PM in a medical context (Dieckmann, Redderson, Wehner, & Rall, 2006;Grundgeiger, Liu, Sanderson, Jenkins, & Leane, 2008). Furthermore, given that nurses spend much of their day in a high prospective load situation trying to maintain different types of prospective memory tasks (event-and time-based), it is surprising to find only two studies on prospective load, both examining event-based load only using a typical laboratory paradigm.…”