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

Abstract

This study has confirmed that interruptions are frequent and result in clinical errors and procedural failures, compromising patient safety. These interruptions contribute a substantial additional workload to medication tasks. Various interventions should be implemented to reduce non-patient-related interruptions. Medication systems and procedures are advocated, that reduce the need for joint double-checking of medications, indirectly avoiding interruptions.

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

“…At times, they would defer to alternative viewpoints to confirm or clarify their knowledge (Cranley, Doran, Tourangeau, Kushniruk, & Nagle, ). As the key personnel involved in medication administration nurses spent considerable time facilitating the collection of information, framing options for patients and other HPs and filtering information prior to deciding on the appropriate action as others have found (Johnson et al., ; Liu, Gerdtz, & Manias, ; Manias, Aitken, & Dunning, ).…”

“…This was found in another study where repetitive travelling across different ward spaces by HPs resulted in multiple interruptions, time wasting and delayed medication administration (Lui, Manias & Gerdtz, ). Other research has shown the frequency of interruptions during medication preparation and administration, where nurses are the main source of interruptions and the interruptions are largely unrelated to patient care (Johnson et al., ; Westbrook et al., ).…”

Overseas qualified nurses’ communication with other nurses and health professionals: An observational study

“…Time pressures exerted by colleagues resulted in shortcuts in communication activities where a communication protocol was required to ensure patient safety. Numerous studies have demonstrated that such time pressures can curtail crucial clinical communication processes and be detrimental to patient safety (Eggins & Slade, ; Johnson et al, ; Manias, Geddes, et al, ). The implication for intra‐ and interprofessional communication is that safe and effective communication is the joint responsibility of all interactants.…”

“…By its very nature, inter‐ and intraprofessional communication is complex due to the myriad clinical settings across which health professionals communicate, as well as due to time pressures and interruptions. Such factors can compromise patient safety (Johnson et al, ; Manias, Gerdtz, Williams, McGuiness, & Dooley, ). For instance, studies have underscored that interruptions during clinical handover between healthcare team members can potentially contribute to near misses, disruptions in patient care, critical incidents and mortality (Eggins & Slade, ; Manias, Geddes, et al, ).…”

An urban medical system's exploratory study of medication errors

“…A variety of measures have been attempted to ensure that the nurse preparing and administering medications can do so with as few interruptions as possible. Some include lighted lanyards which alert staff, visitors and people that the nurses are on medication rounds and should not be unnecessarily interrupted, the “sterile cockpit” approach has been tried by some organizations with limited success (Kapur, Parand, Soukup, Reader, & Sevdalis, ), medication preparation areas can be marked or cordoned off and only permit one nurse at a time to enter and procure medications (Hayes, Jackson, Davidson, Daly, & Power, ), and some have adopted a strategy where the nurse who is giving medication dons a brightly coloured vest to denote that medication rounding is occurring (Johnson et al, ). Unfortunately, all of these methods may promote a sense, at least from people and families that the nurses should never be interrupted.…”