Interruptions and Medication Errors Part I

Internal Medicine Services, Baylor University Medical Center, Dallas, Texas, USA.
Clinical nurse specialist CNS (Impact Factor: 0.99). 08/2012; 24(6):281-5. DOI: 10.1097/NUR.0b013e3181faf78b
Source: PubMed
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    ABSTRACT: In the fast-paced environment of a cardiac and thoracic surgery telemetry unit, nurses are interrupted hundreds of times per day. These interruptions can have a detrimental effect on patient safety during medication administration. This article describes a bundle of safety interventions that reduced the average number of interruptions during medication administration by 2.11 interruptions per encounter and decreased reported medication errors by a total of 28 incidents over a 3-month period.
    Journal of nursing care quality 10/2012; 28(2). DOI:10.1097/NCQ.0b013e318275ac3e · 1.39 Impact Factor
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    ABSTRACT: The purpose of this review was to explore what is known about interruptions and distractions on medication administration in the context of undergraduate nurse education. Incidents and errors during the process of medication administration continue to be a substantial patient safety issue in health care settings internationally. Interruptions to the medication administration process have been identified as a leading cause of medication error. Literature recognises that some interruptions are unavoidable; therefore in an effort to reduce errors, it is essential understand how undergraduate nurses learn to manage interruptions to the medication administration process. Systematic, critical literature review. Utilising the electronic databases, of Medline, Scopus, PubMed and CINAHL, and recognised quality assessment guidelines, 19 articles met the inclusion criteria. Search terms included: nurses, medication incidents or errors, interruptions, disruption, distractions and multitasking. Researchers have responded to the impact of interruptions and distractions on the medication administration by attempting to eliminate them. Despite the introduction of quality improvements, little is known about how nurses manage interruptions and distractions during medication administration or how they learn to do so. A significant gap in the literature exists in relation to innovative sustainable strategies that assist undergraduate nurses to learn how to safely and confidently manage interruptions in the clinical environment. Study findings highlight the need for further exploration into the way nurses learn to manage interruptions and distractions during medication administration. This is essential given the critical relationship between interruptions and medication error rates. Better preparing nurses to safely fulfil the task of medication administration in the clinical environment, with increased confidence in the face of interruptions, could lead to a reduction in errors and concomitant improvements to patient safety. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12944 · 1.26 Impact Factor
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    ABSTRACT: AimThis study was conducted in an attempt to examine the number and duration of interruptions during the medication preparation process and to identify the factors causing these interruptions.Background Interruptions during the medication preparation process can cause medication errors owing to nurses' lack of attention.MethodA descriptive study was conducted at the Internal Diseases and General Surgery services of a university hospital between 15 June 2012 and 30 July 2012. The data were collected using the ‘Observation Form of Preparing Medication.’ResultA total of 122 observations were made in the study. It was found that there was an interruption during the process of preparing medication in 95.9% of observations. The average number (±SD) of interruptions was 5.8 ± 4. The individuals causing the interruption during medication preparation were primarily nurses working in the same service. Receiving from or giving materials to the treatment room were the main reasons for the interruptions.Conclusion This study found a very high interruption rate during the process of preparing medications.Implications for nursing managementAs interruptions during medication preparation can cause medical errors, in-service teaching should be provided to raise awareness for this important issue. The findings of the study can be useful for enhancing the conditions of the physical environment, separating the treatment rooms and using the treatment rooms only for preparing medication.
    Journal of Nursing Management 09/2015; DOI:10.1111/jonm.12331 · 1.50 Impact Factor