Search results for "Interruptions and distractions"

Distractions and interruptions are prevalent in health care delivery. This conference report reviews types of distractions in anesthesiology, their likelihood to introduce significant risks into care processes, and strategies to help manage distractions.

Interruptions are a known patient safety hazard. This direct observation study demonstrated that intensive care unit nurses were interrupted about every 20 minutes. Interruptions by physicians were of longer duration and were more likely to result in the nurse moving to another activity. The authors conclude that further study is needed to determine the clinical significance of interruptions in the intensive care unit setting.

This randomized controlled trial had nurses on four hospital wards wear "do not interrupt" vests during medication administration. The rate of interruptions the intervention nurses experienced was compared to the rate in four control wards that did not have nurses wear vests. Although the intervention reduced non–medication-related interruptions, nurses reported that the vests were time consuming and uncomfortable; less than half would support continuing the intervention. This study demonstrates the need to design and test sustainable interventions to improve patient safety.

Interruptions are known to contribute to medication errors. This direct observation study found that resident physicians and physician assistants experienced 57 interruptions per 100 medication orders. The authors suggest that inpatient health systems should implement strategies to reduce interruptions during medication ordering.

Reducing the number of alarms can help alleviate alarm fatigue and the associated patient safety hazards. In this study, researchers successfully implemented a number of interventions which led to a 61% decrease in average alarms per monitored bed in a cardiovascular surgical intensive care unit and a reduction in cardiorespiratory events.

Interruptions are known to contribute to medication administration errors. This pre–post study found that nurses experienced fewer interruptions and made fewer medication errors following the introduction of a separate medication room. These results demonstrate how changing the work environment can promote safety.

Noise in the operating room can contribute to miscommunication, stress, and fatigue. This commentary describes a project that established a designated quiet space in an outpatient surgical setting to decrease opportunities for distraction in perioperative care and provided education regarding the importance of noise reduction.

Disruptive clinician behavior has a negative effect on teamwork that could contribute to patient harm. Examining the literature on disruptive behavior in the operating room, this review identified intrapersonal, organizational, and interpersonal factors that facilitate disruptive conduct and discussed its impact on teams, clinicians, patients, and organizations. The authors recommend strategies to address disruptive behaviors among clinicians such as documenting standards of behavior.

Interruptions are prevalent in health care delivery settings. This review discusses epidemiology, quality improvement, cognitive systems engineering, and applied cognitive psychology as prominent research traditions examining interruptions in health care. The authors suggest that a more integrated approach that combines perspectives from these research traditions could enhance design of interventions to reduce interruptions.

Prior research demonstrates that interruptions in health care can compromise patient safety. In this study, researchers observed interruptions experienced by nuclear medicine technologists in their work environment and found that some interruptions were helpful. In addition, technologists had developed personal strategies to optimize for safety.

Interruptions are common in care settings and can introduce safety hazards into health care processes. This commentary describes an observational method to explore factors that contribute to interruptions from various perspectives to better understand the reasons for interruptions and design strategies to manage them. A past PSNet perspective discussed an approach to reduce interruptions.

Chemotherapy medications can cause severe patient harm if incorrectly dosed or administered. This cross-sectional survey of oncology nurses revealed that most chemotherapy double-checking is conducted jointly rather than independently. Of note, many nurses reported being interrupted to engage in a double-check.

Personal electronic devices such as smartphones are now ubiquitous, and many clinicians use them for both work and personal purposes. Although considered a necessity, these devices can serve as a distraction, which could compromise patient safety. This review found that many certified registered nurse anesthetists and anesthesiologists acknowledge using personal electronic devices in the operating room despite knowledge of the potential risks. Currently, no formal guidelines exist regarding what constitutes inappropriate use of such devices in the operating room. The authors call for further research in order to develop policies to balance the risks and benefits of personal electronic devices. A WebM&M commentary discusses a case where an interruption due to receiving a text message on a smartphone led to a serious medication error.

Medication administration errors are common and are often associated with interruptions. This study reviews data from a recent study on medication safety in critical access hospitals and recommends organizational strategies to improve the safety of medication administration.

Interruptions and distractions are well-recognized sources of error. Distractions in the operating room are common. In this randomized crossover study, researchers observed residents performing a virtual salpingectomy and subjected them to time periods in which they received pages versus quiet phases without interruptions. The majority of residents made at least one unsafe clinical decision while trying to multitask, further supporting that interruptions and distractions adversely impact patient safety.

Despite the ubiquity of smartphones, the vast majority of physicians still rely on one-way pagers for communication. This study analyzed the frequency and content of pages on an internal medicine service at a teaching hospital and compared the data to a similar study performed in 1988. Physicians received an average of 22 pages per day, of which 76% were deemed clinically relevant by independent reviewers and 82% required a response. This represented a nearly 50% increase in the volume of pages compared to 1988. Doctors on regionalized services (where patients were admitted to a common unit) received significantly fewer pages than those caring for patients on nonregionalized services, implying that regionalized services may aid face-to-face communication. As interruptions have been shown to negatively affect patient safety, the authors advocate for developing secure two-way methods of communication (such as secure text messaging) for nurses and physicians in order to improve the efficiency of communication around clinical issues.

Interruptions are a common occurrence in health care. This commentary suggests that research about interruptions clearly determine definitions, data collection methods, and processes that are affected to enhance understanding regarding the impact of disruptions on patient safety.

Interruptions can lead to errors in care, but they may be necessary to address urgent situations. This direct observation and device audit study classified nursing interruptions as either detrimental or necessary. Investigators determined that interrupting a nurse in the patient room was most likely to be a safety hazard, whereas alerts to nurses outside of patient rooms were more likely to be beneficial. This work underscores the challenge of optimizing interruptions to maintain patient safety.

Interruptions and task-switching are common contributors to complexity in emergency care. Exploring behaviors associated with multitasking in various disciplines, including human factors engineering, cognition science, and business, this review outlines a framework for enhancing understanding of multitasking, such as whether it can be performed successfully and types of actions that can be combined safely.

Workflow interruptions are often a necessary reality in busy clinical settings, but they can pose serious risks for patient safety. This mixed-method study in a medium-sized community emergency department (ED) found that ED personnels' workflow was disrupted on average 5.6 times per hour and that nearly a third of time was spent on multitasking activities. Similar to a prior study by some of the same authors, interruptions were common and associated with higher perceived workload. In this study, ED professionals' mental workload was negatively related to patients' perceived quality of care and their general satisfaction with their care. However, workflow interruptions were also associated with better patient-related information on discharge and overall quality of transfer, suggesting a more nuanced role for the consequences of interruptions. A prior AHRQ WebM&M perspective discussed interruptions and distractions in health care.