Schroers G, Tell D, O'Rourke J. Association of external interruptions with increased medication administration duration and self-interruptions: A direct observational study: Empirical research quantitative.
J Adv Nurs 2023;
79:4339-4347. [PMID:
37070669 DOI:
10.1111/jan.15674]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/07/2023] [Accepted: 04/07/2023] [Indexed: 04/19/2023]
Abstract
AIMS
To examine task duration and frequency of self-interruptions among study participants during externally interrupted compared with externally uninterrupted simulated medication administration.
BACKGROUND
Interruptions are prevalent during nursing medication administration and can lead to inefficient, delayed, omitted and unsafe patient care. Interrupted nursing tasks are shown to take longer to complete compared to uninterrupted tasks; however, studies seldom indicate if the time spent in the interruption was included or excluded in the reported task duration. It is unknown if the time spent in the interruption leads to longer task completion times or if other factors, such as the time needed to re-engage in the primary task and/or self-interruptions, are involved. Little is known about associations between external interruptions and self-interruptions during nursing tasks. Self-interruptions are caused by an individual's own decision to stop an activity to attend to something else.
DESIGN
Cross-sectional within-subjects design.
METHODS
This two-site study investigated task duration and frequencies of self-interruptions during externally interrupted and externally uninterrupted simulated medication administration. Data on medication administration duration, external interruption duration and self-interruptions were collected via direct observation from November 2019-February 2020. The time spent in the external interruption was deducted from the medication administration duration.
RESULTS
Thirty-five participants were included in the study. The externally interrupted task had a significantly longer duration and significantly more frequent self-interruptions within-subjects compared to the externally uninterrupted task. Self-interruptions were most often due to forgotten supplies.
CONCLUSIONS
The findings suggest that the time needed to re-engage with an externally interrupted task and/or self-interruptions may lead to longer task completion times.
IMPACT
Researchers are encouraged to investigate mediators of interruptions that lead to longer task completion times and errors. Findings can be used to develop and implement interruption management strategies that aim to improve the safety and quality of patient care.
REPORTING METHOD
Equator guidelines were followed using the STROBE reporting method.
PATIENT/PUBLIC CONTRIBUTION
No patient or public involvement in this study.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE
Educators and researchers can use the study findings to guide teaching methods and direct future studies. By gaining a better understanding of the mediators of interruptions that create longer task completion times and increase the risk for errors, tailored interruption management strategies that aim to improve the safety and quality of healthcare can be developed and implemented.
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