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Interruptions decrease the efficiency of the medication administration process. In this study, interruptions were found in 63% of the medication passes on four medical-surgical units in a community hospital. However, interruptions do not always lead to negative outcomes.
Interruptions are ubiquitous in the complex healthcare workplace (Colligan & Bass, 2012; Fore, Sculli, Albee, & Neily, 2013; Freeman, McKee, Lee-Lehner, & Pesenecker, 2013; Westbrook, Woods, Rob, Dunsmuir, & Day, 2010). In medication administration, nurses have a chance of being interrupted with every medication pass (Smeulers, Hoekstra, van Dijk, Overkamp, & Vermeulen, 2013). Interruptions decrease efficiency by lengthening medication administration time (McComas, Riingen, & Kim, 2014). Nurses may need to collect their thoughts and revisit their original purpose after each interruption during medication administration in the hospital setting (Clark & Flanders, 2012). Nurses must look critically at types of interruptions to determine strategies for addressing them.
Literature Review
The following databases were used: CINAHL Complete, Healthsource: Nursing/Academic Edition, Academic Search Complete, and Medline. Search terms included interruptions, medication administration, patient safety, and efficiency. The search was confined to studies published 2009-2016.
Biron, Lavoie-Tremblay, and Loiselle (2009) studied 102 medication administration rounds using direct observation at a tertiary care university teaching hospital in Quebec, Canada. They found nurses were interrupted at least once during 53.9% of observations, with an average of 6.3 work interruptions per hour. Nurse colleagues (29.3%) and system failures (22.8%; including missing medication or equipment) represented the most frequent interruptions during medication preparation. Nurses passing the medication (16.9%) and patients (16%) accounted for the most interruptions during medication administration. This study was noteworthy for pinpointing the actual source of the interruptions and documenting their frequency. However, it did not analyze interruptions by time of day or attempt to correlate number of frequencies and time for administration.
Nguyen, Connolly, and Wong (2010) studied 100 medication administration observations during a medication pass timeout at a 600bed academic teaching hospital in California. Compared to 53.9% interruptions in the study by Biron and colleagues (2009), which had no timeout, 19% of the observations in this study had interruptions. Nguyen and co-authors (2010) also found reducing interruptions resulted in 100% of medications administered without errors. This study was important in demonstrating a timeout intervention could lead to a marked...