Using Simulation-Based Education to Teach Interruption Management Skills: An Integrative Review

Hill, Peggy P.; Díaz, Desiree A.; Anderson, Mindi; Talbert, Steven; Maraj, Crystal S.

doi:10.1016/j.ecns.2021.12.002

Cited by 3 publications

(6 citation statements)

References 47 publications

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“…Determining ways to reduce distractions and interruptions (especially during high-volume medication times) and teaching nurses strategies for dealing with such disruptions should be prioritized. Innovative approaches such as simulation-based education can be used to teach nursing students and novice nurses interruption management skills 29. The ability to manage interruptions has been shown to lower nurses' sense of overwhelm, decrease risk of error, and improve practice efficiency 29.…”

Section: Discussionmentioning

confidence: 99%

“…Innovative approaches such as simulation-based education can be used to teach nursing students and novice nurses interruption management skills. 29 The ability to manage interruptions has been shown to lower nurses' sense of overwhelm, decrease risk of error, and improve practice efficiency. 29 Addressing environmental aspects such as the location of and noise levels in medication rooms can also be helpful.…”

Section: System Influencesmentioning

confidence: 99%

“…29 The ability to manage interruptions has been shown to lower nurses' sense of overwhelm, decrease risk of error, and improve practice efficiency. 29 Addressing environmental aspects such as the location of and noise levels in medication rooms can also be helpful.…”

Section: System Influencesmentioning

confidence: 99%

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Original Research: Exploring Medication Safety Practices from the Nurse's Perspective

Arkin,

Schuermann,

Loerzel

et al. 2023

AJN, American Journal of Nursing

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Background: Medication preparation and administration are complex tasks that nurses must perform daily within today's complicated health care environment. Despite more than two decades of efforts to reduce medication errors, it's well known that such errors remain prevalent. Obtaining insight from direct care nurses may clarify where opportunities for improvement exist and guide future efforts to do so. Purpose: The study purpose was to explore direct care nurses' perspectives on and experiences with medication safety practices and errors. Methods: A qualitative descriptive study was conducted among direct care nurses employed across a large health care system. Data were collected using semistructured interview questions with participants in focus groups and one-on-one meetings and were analyzed using qualitative direct content analysis. Results: A total of 21 direct care nurses participated. Four major themes emerged that impact the medication safety practices of and errors by nurses: the care environment, nurse competency, system influences, and the error paradigm. These themes were often interrelated. Most participants depicted chaotic environments, heavy nursing workloads, and distractions and interruptions as increasing the risk of medication errors. Many seemed unsure about what an error was or could be. Conclusions: The complexity of medication safety practices makes it difficult to implement improvement strategies. Understanding the perspectives and experiences of direct care nurses is imperative to implementing such strategies effectively. Based on the study findings, potential solutions should include actively addressing environmental barriers to safe medication practices, ensuring more robust medication management education and training (including guidance regarding the definition of medication errors and the importance of reporting), and revising policies and procedures with input from direct care nurses.

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Section: Discussionmentioning

confidence: 99%

Section: System Influencesmentioning

confidence: 99%

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Original Research: Exploring Medication Safety Practices from the Nurse's Perspective

Arkin,

Schuermann,

Loerzel

et al. 2023

AJN, American Journal of Nursing

View full text Add to dashboard Cite

show abstract

“…Simulation affords a safe environment to practice interruption management during high-risk tasks, such as MA. However, a recent integrative review (Hill et al, 2022) of studies that used simulation to teach participants (including nurses, medical students, and nursing students) interruption management found that most used experiential learning only. In other words, participants were provided the opportunity to feel what it was like to be interrupted but were not taught how to handle interruptions.…”

Section: Tablementioning

confidence: 99%

Investigation of a Behavioral Interruption Management Strategy on Improving Medication Administration Safety and Efficiency: A Feasibility Study

Schroers,

Pfieffer,

Tell

et al. 2023

Preprint

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Background: Worldwide, interruptions are pervasive during nurse medication administration and associated with increased frequency and severity of errors. Interruptions also decrease task efficiency which can lead to delayed or omitted patient care. Interruptions cannot always be avoided in healthcare settings; thus, researchers recommend the use of interruption management strategies to mitigate interruptions' negative effects. Aims: To investigate the feasibility and potential of a behavioral interruption management strategy to mitigate medication errors and improve task efficiency. Design: Multi-methods, two groups, repeated measures, pre-posttest design. Methods: Data were collected January-March 2023. Volunteer undergraduate nursing students were randomly assigned to a control or intervention group. The intervention group received education and training on an interruption management strategy. Quantitative data were collected across three timepoints via direct observation of independent demonstrations of simulated medication administration. The simulated scenarios contained embedded interruptions. Outcomes measured included errors, medication preparation duration, and duration of time to implement the interruption management strategy. Descriptive statistics were analyzed using Microsoft Excel. Qualitative data of participants' perceptions and use of the strategy were collected via semi-structured interviews. Thematic analysis was performed. Reporting Method: Equator guidelines were followed using the STROBE reporting method for the observed quantitative data. SRQR guidelines were followed in reporting the qualitative data. Results: Nineteen students participated in the study. Intervention group participants had larger improvements in errors and task durations compared to the control group. Implementation of the strategy averaged four seconds. Participants described the strategy as easy to use and remember, and voiced using the strategy outside of the study. Conclusions: Findings demonstrate that the study-described behavioral interruption management strategy was feasible to teach and implement, and associated with decreased errors and improved task efficiency. Use of the strategy has implications to increase patient safety through improved medication administration safety and efficiency. Future studies are recommended to gain a better understanding of the strategy's effectiveness.

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“…Thomas et al, 2014). However, an integrative literature review of the use of SBE to teach interruption management revealed that simulations vary in rigor and typically rely on experience alone, without first providing interruption management training (Hill et al, 2022). Jeffries (2014) stated that learning outcomes are optimal when SBE builds on prior knowledge.…”

Section: Introductionmentioning

confidence: 99%

Remembering to Resume: A Randomized Trial Comparing Combined Interruption Management Training and Simulation-Based Education to Simulation-Based Education Alone

et al. 2023

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AIMThis study aimed to determine if purposeful presimulation interruption management training impacts cognitive load and successful completion of simulation objectives more than the experience alone.BACKGROUNDPracticing nurses are frequently interrupted, increasing the risk for error and task time. Novices are particularly vulnerable to interruption consequences.METHODA between-subjects design and block randomization of prelicensure baccalaureate nursing students (n = 146) was used to compare group differences in cognitive load, use of interruption management strategies, and completion of simulation required elements. Potential relationships between outcomes and age, mindfulness, and experience were explored.RESULTSAn analysis of covariance demonstrated significantly lower perceived mental demand for those receiving training. Older learners and those receiving training implemented more interruption management strategies.CONCLUSIONCombining simulation-based education (SBE) with purposeful training enhances interruption management more than SBE alone. Frequent interruption training and SBE are recommended to enhance risk awareness.

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Using Simulation-Based Education to Teach Interruption Management Skills: An Integrative Review

Cited by 3 publications

References 47 publications

Original Research: Exploring Medication Safety Practices from the Nurse's Perspective

Original Research: Exploring Medication Safety Practices from the Nurse's Perspective

Investigation of a Behavioral Interruption Management Strategy on Improving Medication Administration Safety and Efficiency: A Feasibility Study

Remembering to Resume: A Randomized Trial Comparing Combined Interruption Management Training and Simulation-Based Education to Simulation-Based Education Alone

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