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Healthcare settings can be hectic, demanding, time-constrained environments. Within these environments, healthcare professionals perform complex cognitive tasks 1 2 that often require their undivided attention. Interruptions such as phone calls, pages, other healthcare professionals' requests, equipment failures, alarms, patients and patients' families disrupt healthcare professionals throughout their day and potentially interfere with their already demanding workload.
The Institute of Medicine's 2000 report, To Err Is Human, identified interruptions as a likely contributing factor to medical errors. 3 Literature has reported that interruptions can be disruptive and can often hinder healthcare professionals from successfully completing their tasks. 4-6 However, some interruptions are essential to the patient care process and provide healthcare professionals with necessary information (eg, a patient's monitor alarming because of abnormal vital signs).
Interruptions have implications for safe and high-quality healthcare delivery, thus this article systematically reviews the peer-reviewed literature on interruptions in healthcare settings to determine the state of the science and to identify gaps. It then discusses the implications of the reviewed literature and suggests directions for future research to develop a better understanding of interruptions in healthcare.
Method
Inclusion and exclusion criteria
The inclusion criteria were as follows: (1) the article's domain was healthcare; (2) one of the main focuses of the article was interruptions or the concept of shifting attention away from a primary task (related terms were disruptions, distractions, breaks-in-task, etc); (3) the article was published in a peer-reviewed journal; (4) the article presented empirical data; (5) the article was published before 1 August 2008 and (6) the article was available in the English language. Articles were excluded if they only contained conceptual or theoretical discussions of interruptions.
Search strategy
The online databases PubMed and Web of Knowledge-CrossSearch were searched (the latter simultaneously searched under Arts and Humanities Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, Biological Abstracts, MEDLINE and Zoological Record) using the following search phrases: (1) healthcare* AND interrupt*; (2) health care* AND interrupt* (which was subsequently disregarded because it provided too many irrelevant articles); (3) nurse* AND interrupt*; and (4) physician* AND interrupt*. These searches yielded a total of 2387 articles. Colleagues were also requested to provide any relevant papers that might meet the inclusion criteria. Fifteen papers met the inclusion criteria. A...