TY - JOUR
T1 - Interruptions during intravenous medication administration
T2 - A multicentre observational study
AU - Schutijser, Bernadette C F M
AU - Klopotowska, Joanna E
AU - Jongerden, Irene P
AU - Spreeuwenberg, Peter M M
AU - De Bruijne, Martine C
AU - Wagner, Cordula
N1 - Funding Information: This study was funded by the Dutch Ministry of Health, Welfare, and Sports. Publisher Copyright: © 2018 John Wiley & Sons Ltd Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - AIMS: The aim of this study was to determine the frequency and cause of interruptions during intravenous medication administration, which factors are associated with interruptions and to what extent interruptions influence protocol compliance.BACKGROUND: Hospital nurses are frequently interrupted during medication administration, which contributes to the occurrence of administration errors. Errors with intravenous medication are especially worrisome, given their immediate therapeutic effects. However, knowledge about the extent and type of interruptions during intravenous medication administration is limited.DESIGN: Multicentre observational study.METHODS: Data were collected during two national evaluation studies (2011 - 2012 & 2015 - 2016). Nurses were directly observed during intravenous medication administration. An interruption was defined as a situation where a break during the administration was needed or where a nurse was distracted but could process without a break. Interruptions were categorized according to source and cause. Multilevel logistic regression analyses were conducted to assess the associations between explanatory variables and interruptions or complete protocol compliance.RESULTS: In total, 2,526 intravenous medication administration processes were observed. During 291 (12%) observations, nurses were interrupted 321 times. Most interruptions were externally initiated by other nurses (19%) or patients (19%). Less interruptions occurred during the evening (odds ratio: 0.23 [95% confidence interval: 0.08-0.62]). Do-not-disturb vests were worn by 61 (2%) nurses. No significant association was found between being interrupted and complete protocol compliance.CONCLUSION: An interruption occurred in every eight observed intravenous medication administration, mainly caused by other nurses or patients. One needs to consider critically which strategies effectively improve safety during the high-risk nursing-task of intravenous medication administration.
AB - AIMS: The aim of this study was to determine the frequency and cause of interruptions during intravenous medication administration, which factors are associated with interruptions and to what extent interruptions influence protocol compliance.BACKGROUND: Hospital nurses are frequently interrupted during medication administration, which contributes to the occurrence of administration errors. Errors with intravenous medication are especially worrisome, given their immediate therapeutic effects. However, knowledge about the extent and type of interruptions during intravenous medication administration is limited.DESIGN: Multicentre observational study.METHODS: Data were collected during two national evaluation studies (2011 - 2012 & 2015 - 2016). Nurses were directly observed during intravenous medication administration. An interruption was defined as a situation where a break during the administration was needed or where a nurse was distracted but could process without a break. Interruptions were categorized according to source and cause. Multilevel logistic regression analyses were conducted to assess the associations between explanatory variables and interruptions or complete protocol compliance.RESULTS: In total, 2,526 intravenous medication administration processes were observed. During 291 (12%) observations, nurses were interrupted 321 times. Most interruptions were externally initiated by other nurses (19%) or patients (19%). Less interruptions occurred during the evening (odds ratio: 0.23 [95% confidence interval: 0.08-0.62]). Do-not-disturb vests were worn by 61 (2%) nurses. No significant association was found between being interrupted and complete protocol compliance.CONCLUSION: An interruption occurred in every eight observed intravenous medication administration, mainly caused by other nurses or patients. One needs to consider critically which strategies effectively improve safety during the high-risk nursing-task of intravenous medication administration.
KW - distractions
KW - injectable medication
KW - interruptions
KW - intravenous medication
KW - multicentre
KW - nurse
KW - observations
UR - http://www.scopus.com/inward/record.url?scp=85056859510&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85056859510&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30334590
U2 - https://doi.org/10.1111/jan.13880
DO - https://doi.org/10.1111/jan.13880
M3 - Article
C2 - 30334590
SN - 0309-2402
VL - 75
SP - 555
EP - 562
JO - Journal of advanced nursing
JF - Journal of advanced nursing
IS - 3
ER -