Interruptions during nurses' work: A state‐of‐the‐science review

Abstract

The purpose of this state-of-the-science review was to examine empirical evidence from studies of interruptions conducted in acute care nurses' work environments. A total of 791 articles published from 2001 through 2011 were reviewed; 31 met the criteria to be included in the sample. Despite sustained multinational and multidisciplinary attention to interruptions during nurses' work, the current findings suggest that beliefs about the ill effects of interruptions remain more conjecture than evidence-based. Pre-existing beliefs and biases may interfere with deriving a more accurate grasp of interruptions and their effects. Future research would benefit from examinations of interruptions that better capture their complexity, to include their relationships to both positive and negative outcomes for both patients and health care workers.

Managing perturbations during handover meetings: a joint activity framework

“…Enacting such procedures may be supported by hospital guidelines, but may also ultimately hinge on handover participants themselves deciding how to best protect boundaries – given that they themselves are likely the commonest source of perturbations. The distinction between a perturbation and an interruption highlights the active nature of boundary management work nurses do and contributes towards a better understanding of the complexity of interruptions in medical settings (Hopkinson & Jennings 2013). …”

“…Handover participants deploy collaborative actions to keep perturbations from becoming interruptions. Research is needed to better understand the complexities of perturbations and develop strategies to manage them (Kalisch & Aebersold 2010, Hopkinson & Jennings 2013). …”

Nurses' experiences with errors in nursing

“…Variations in the nurse's work environment shaped both the origin of and response to the error and impacted the ability of the nurse to provide high quality care (Steege, Drake, Olivas & Mazza, 2015). The contributions of complex environmental factors that characterize nursing work and lead to failures in delivery of care are well documented in the literature (Sitterding, Ebright, Broome & Patterson, 2014;Foroungi, Weber et al 2013;Hopkinson & Jennings, 2013;Ebright, 2010;Hall et al, 2010;). That nurses participating in this study were able to recall details surrounding an error supports the notion that retrieving details of an event from those involved in the situation is a productive method for learning why things happened the way they did.…”

How do interruptions affect clinician performance in healthcare? Negotiating fidelity, control, and potential generalizability in the search for answers

“…There is a vast number of field investigations of interruptions and distractions in healthcare (see reviews by Coiera, 2012;Hopkinson & Jennings, 2013;Li, Magrabi, & Coiera, 2012;Rivera & Karsh, 2010). We have selected three to discuss : Westbrook et al's (2010) observational study of the impact of interruptions on nurses' work during medication rounds, Grundgeiger, Sanderson, MacDougall, and Venkatesh's (2010) eye-tracking study of nurses' ability to resume interrupted tasks, and Rivera's (2014) field study of how nurses make decisions to interrupt other nurses, combining ethnographic observation and interviews.…”

“…The three intervention studies described have not been motivated by theoretical accounts of how interruptions might lead to harm, but instead by the practical goal of improving the accuracy of medication administration and removing the potential for error. Indeed, given that the evidence for a causal connection between interruptions and errors is still tenuous Hopkinson & Jennings, 2013;Raban & Westbrook, 2014) and given reports of paradoxical outcomes (Tomietto et al, 2012) it is arguable that intervention studies are premature. Elsewhere we have argued that to draw a connection between interruptions and harm, we need a theory not just of the effect of interruptions on human cognition, but also of how accidents occur .…”