Search results for "Interruptions and 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.

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.

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.

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.

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.

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.

Interruptions are inevitable in the clinical environment, and they have been linked to an increased risk of diagnostic errors by radiologists and medication administration errors by nurses. However, the effects of interruptions are not predictable and many interruptions are essential for proper patient care. Recognizing this, commentators have called for research to analyze the causes and effects of interruptions, rather than attempting to categorically prevent interruptions. This study, conducted in an academic emergency department, contributes to our understanding of how interruptions influence patient care by examining the effect of interruptions on several specific nursing tasks. Interventions that were interrupted took longer than uninterrupted tasks, and interruptions were a significant contributor to overall nursing workload. Patients and families were the most frequent source of interruptions, demonstrating that simply implementing interventions to prevent interruptions could cause unintended consequences. The state of patient safety in the emergency department, including the role of interruptions, is discussed in a past AHRQ WebM&M perspective.

Implementation of a safe zone—which included marked quiet areas for medication preparation, adhering to a checklist for medication processes, and educating staff about distractions—to minimize interruptions during medication administration did not improve medication error rates, but was associated with an increase in patient satisfaction.

This study surveyed nurses in neonatal intensive care units about missed nursing care. As in other care settings, missed nursing care is significant, and reasons include interruptions, urgent patient situations, and increases in patient volume. This finding underscores the need to enhance nursing workflow to prevent errors of omission.

In this prospective observational study at a psychiatric hospital, errors were identified in 3% of medication administration episodes, with omission being the most common error type. As in prior studies, interruptions and higher patient volume were associated with increased risk of mistakes.

Interruptions are inevitable for busy clinicians, and recently studies have shown that interruptions can increase workload for physicians and raise the risk of medication administration errors by nurses. However, these safety risks must be balanced against the fact that interruptions are often necessary for patient care. This study analyzed data from telephone logs and a formal quality assurance program to examine the effect of telephone interruptions on accuracy of on-call radiology residents' study interpretations. The authors found that a higher frequency of interruptions was associated with more diagnostic errors. This study is one of the first to document clinical consequences of physician interruptions and adds to our understanding of systems contributors to diagnostic errors. An incident involving an incorrect overnight radiology interpretation is discussed in a past AHRQ WebM&M commentary.

This direct observation study revealed that surgeons performed with less dexterity and made more errors when distractions were present in the operating room compared to when no distraction occurred, and this effect was more pronounced in those with less experience. Consistent with prior work on interruptions and distractions, this finding underscores the need to augment health care work environments to improve safety.

This qualitative study characterized safety hazards in medication dispensing in community pharmacies. The authors conclude that the major sources of risk pertained to interruptions and distractions, which were often exacerbated by production pressures.

Exploring the existing evidence on interruptions in health care, this commentary reveals that most studies focus on the rate of interruptions rather than the relationship between interruptions and errors. The author calls for research to evaluate how use of multitasking behaviors to manage interruptions and to differentiate between appropriate interruptions that prevent errors and those that contribute to preventable harm.

Interruptions are often cited as a source of potential errors in nursing care. However, this qualitative study found that emergency department nurses perceived their ability to multitask and handle interruptions as a necessary skill and an important source of professional pride.