Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration

Abstract

BACKGROUND Because of the high frequency of interruptions during medication administration, the effectiveness of strategies to limit interruptions during medication administration has been evaluated in numerous quality improvement initiatives in an effort to reduce medication administration errors. OBJECTIVES To evaluate the effectiveness of evidence-based strategies to limit interruptions during scheduled, peak medication administration times in 3 progressive cardiac care units (PCCUs). A secondary aim of the project was to evaluate the impact of limiting interruptions on medication errors. METHODS The percentages of interruptions and medication errors before and after implementation of evidence-based strategies to limit interruptions were measured by using direct observations of nurses on 2 PCCUs. Nurses in a third PCCU served as a comparison group. RESULTS Interruptions (P < .001) and medication errors (P = .02) decreased significantly in 1 PCCU after implementation of evidence-based strategies to limit interruptions. Avoidable interruptions decreased 83% in PCCU1 and 53% in PCCU2 after implementation of the evidence-based strategies. CONCLUSIONS Implementation of evidence-based strategies to limit interruptions in PCCUs decreases avoidable interruptions and promotes patient safety. (Critical Care Nurse. 2016;36[4]:19-35) This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: 1. Describe similarities between the principles of the sterile cockpit concept used in the aviation industry and the Nurses Uninterrupted Passing Medications Safely (NUPASS) guidelines to promote safety 2. Discuss the current evidence supporting use of interruption limiting strategies to reduce medication administration errors in the acute care setting 3. Implement evidence-based strategies to limit interruptions during medication administration To complete evaluation for CE contact hour(s) for test #C1642, visit www.ccnonline.org and click the "CE Articles" button. No CE test fee for AACN members. This test expires on August 1, 2019.The American Association of Critical-Care Nurses is an accredited provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. AACN has been approved as a provider of continuing education in nursing by the State Boards of Registered Nursing of California (#01036) and Louisiana (#LSBN12). N urses play a critical role in promoting patient safety through surveillance and interception of errors that cause patient harm as hospitals and health care systems strive to become high-reliability organizations. APRN, MS, Advocate Christ Medical Center, 4400 W 95th St, Oak Lawn,.To purchase electronic or print reprints, contact the American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 899-1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, reprints@aacn.org. patient harm, and strategies to reduce interruptions and manage them appropriatel...

Effectiveness of a ‘Do not interrupt’ bundled intervention to reduce interruptions during medication administration: a cluster randomised controlled feasibility study

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The impact of interruptions on medication errors in hospitals: an observational study of nurses

“…This phase of the medication process could form a key focus in educational programmes developed to reduce interruptions, relating to nurses avoiding discussions about non‐urgent and non‐patient related issues when a nurse is preparing medications (Flynn et al . ).…”

“…Using a pre‐post design with comparison units, a recent North American study found reductions in interruptions with one‐third of wards being affected and medication errors occurring in two of the three participating critical care units, including the comparison unit (Flynn et al . ). The interruption limiting strategies included: hourly patient rounds, triage of phone calls, protected medication times, signage reminding staff to limit interruptions, the presence of no interruption zones in medication rooms, nurses wearing visible vests, and the availability of patient and family materials limiting interruptions.…”

Interruptions in the healthcare workplace: a sociotechnical systems approach

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“…Quality improvement researchers reporting the successful implementation of the sterile cockpit point to improvements such as lower rates of interruptions, fewer medication errors, greater efficiency and subjective reports of greater satisfaction [64][65][66][67][68][69][70][71][72][73][74][75][76][77][78]. Verweij and colleagues found significant reductions in interruptions and medication administration errors after implementation of a drug round tabard; however, they note that factors other than the vests probably influenced the results, such as increased involvement from the ward managers during drug rounds who were "eager to reduce , and the perception that the sterile cockpit principle may be incompatible with total patient-centred care [84].…”