Search results for "Interruptions and distractions"

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 known safety hazard that occur frequently. This systematic review proposes that interruptions be considered a process with various potential consequences for multiple actors rather than single events and suggests a human factors approach to addressing interruptions.

Pagers have been a mainstay for urgent clinician–clinician communication for many decades. Increasingly physicians are using a variety of electronic devices, including smartphones and Web-based technologies. This systematic review identified 16 articles that studied different technologies for urgent clinician communication. Each strategy had potential advantages and pitfalls. For example, smartphones are associated with decreased transmission time compared to pagers, but they also result in more clinician interruptions. There is very little evidence linking any specific communication method with benefits for patient care. Future study could more robustly explore which forms of communication are best for clinicians and patients. A prior AHRQ WebM&M commentary describes a case of serious patient harm related to a smartphone interruption.

According to this study, information regarding the plan of care was generally accurately transmitted during resident handoffs in the emergency department. However, medications were often omitted and residents were frequently interrupted.

This direct observation study found that registered nurses, physicians, and nursing aides have frequent interruptions and limited time for shift-change handoffs. This finding suggests that widespread efforts to ensure adequate handoff time and minimize interruptions have not mitigated these problems in hospital settings.

Although interrupting learners' admission case presentations may provide valuable opportunities for teaching, this study found that it may also hinder comprehensive information sharing.

Interruptions pose a significant safety hazard for health care providers performing complex tasks, such as signout or medication administration. However, as prior research has pointed out, many interruptions are necessary for clinical care, making it difficult for safety professionals to develop approaches to limiting the harmful effects of interruptions. Reviewing the literature on interruptions from the psychology and informatics fields, this study identifies several key variables that influence the relationship between interruption of a task and patient harm. The authors provide several recommendations, based on human factors engineering principles, to mitigate the effect of interruptions on patient care. A case of an interruption leading to a medication error is discussed in this AHRQ WebM&M commentary.

This study found that a program designed to minimize interruptions during medication administration successfully reduced self-reported medication administration error rates.

This study of emergency physicians found that interruptions while performing clinical tasks were common and often resulted in the task being delayed or not completed at all.

The majority of individual errors are due to failure to perform automatic or reflexive actions. A major risk factor for these "slips" is being interrupted or distracted while performing a task. This review examined the literature on the incidence, risk factors, and effects of interruptions in several clinical settings, ranging from outpatient clinics to the operating room. Although distractions are common and may be associated with increased risk for error, particularly if they occur during medication administration or signout, the authors point out that many interruptions may be necessary to communicate urgent clinical information. They argue for complexity theory–based research to delineate the harmful and beneficial aspects of interruptions, rather than for interventions that seek to simply eliminate interruptions. Checklists have been widely adopted as a means of preventing errors of omission, which may be precipitated by interruptions.

Focus groups with nurses revealed a wide array of interruptions that inhibited their ability to provide safe, timely care.

This study observed nurses for 4-hour periods and found that interruptions and multitasking were common. Although nurses managed these discontinuities well, the potential for errors is present and should be a target for prevention strategies.

This article explains how interruptions affect cognition and how disruption may lead to errors.

This review article examined the impact of interruptions in critical care and medication dispensing settings.

This article discusses one hospital's effort to understand how interruptions affect care and to improve processes based on experience from other industries.

This study observed emergency room charge nurses and discovered that interruptions and unnecessary information exchange increased their communication load and the potential for errors.

This study used link analysis techniques in observing that face-to-face communication was the most common mode among different provider types in an emergency department. The charge nurse was observed to be the center of communication while interruptions were a common event for both physicians and nurses.

The author discusses how excessive noise affects the safety of care delivery and provides strategies to lessen its impact.

The author discusses some of the research on interruptions and distractions in the nursing environment.

The investigators shadowed emergency department nurses and physicians and identified the types of interruptions that occurred and what factors contributed to them.