Characteristics Of Work Interruptions During Medication Administration

Problem. In modern-day acute care settings, interruptions occur as part of normal work flow. Technology driven task performance intermingles with interpersonal communication, patient care needs, medication administration and distraction within one’s mind. When a task requires attention to detail or a significant amount of our attention, an interruption can be devastating to a patient, the person carrying out the task and the facility they are employed within. In healthcare literature research, a consistent definition of the term interruption was difficult to ascertain. Identifying a consistent definition would support research designed to support a link between interruptions and medical error.

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

According to Pennsylvania Patient Safety Reporting System (PA-PSRS), nurses stated fatigue as a contributing factor to errors related to procedures, treatments, tests, and medication administrations (Gardner, Dubeck, 2016). Many "near" errors, or “close-calls” were also attributed to mental fatigue and lack of recovery time between shifts (Maust Martin, 2015). It is reported that errors and "near" errors are related to factors, such as, lapses in attention, reduced motivation, compromised problem solving, and diminished reaction time. The Joint Commission believes that fatigue is a factor that greatly contributes to the increased number of sentinel events among patients (Gardner, Dubeck, 2016).

Medication administration is one of the first key elements you learn in nursing school. The standard is held high as the clinical instructors ask you to validate why you are giving a medication, what exactly it does, and to make sure that your patient meets the criteria to receive a medication. They watch you check the medication three times before it gets to a patient’s body, ensuring it is correct. However, medication errors stand as the third leading cause of death in the United States. There are endless reasons as to why this is the case, but Brian R. Malone keys in on the idea of “Intimidating Behavior Jeopardizing Medication Safety” How does the demeanor of medication providers effect those administering it? The purpose of this paper is to summarize the thoughts and ideas Malone discusses about the behavior, actions, and words that lead nurses and pharmacists to administer medications that cause adverse events and jeopardize patient safety.

The results of this study was that the percentage of medication errors decreased following the implementation of eMARs. Although medication errors were decreased, the authors found that the eMAR system decreased efficiency and disturbed workflow. The authors state that factors such as missing medications, preparing medication at the bedside, and distractions contributed to this and are factors that can be improved. The author’s identified the presence of several limitation in the study. The use of one individual to collect data created a possibility of bias and the observation of nurses may have affected the behaviors of the nurse. Also, the authors state that the study was not a cause and effect study and was only conducted on one unit which decreased the generalizability of the study. According the hierarchy of evidence for intervention studies, this

In healthcare today, when hospitals are judged upon patient safety standards, it is critical to prevent errors involving medication administration. Distractions while preparing and administering medications, has been report as one of the leading causes of medication errors. Distractions while nurses are administering medications can lead to poor patient outcomes and even sentinel events. Nurses and nurse managers are responsible for maintaining a unit with minimal distractions. When distractions are minimized throughout medication administration process, a decrease in medication errors will occur and lead to increased patient outcomes.

As a leader in the workplace, medication errors mostly occur when the workplace is understaffed with a patient load of full nursing cares that require more attention and care than patients who are independent. Due to being understaffed with a patient load of 13 to 2 nurses, medication errors occur more often as nurses are being rushed to finish all cares within their work timeframe. To decrease medication errors it is important to implement more staff during medication rounds, thus giving nurses additional time to concentrate and assure that the correct medication and dose is being given to the right patient ( ). The 6 medication rights are important to implement into every workplace as it decreases the chances of administrating medication to the wrong patients ( ). The medication right include; ______________________________________________________________ ( ). Medication errors have important implications for patient safety and in improving clinical practice errors to prevent any adverse events (

Nursing burnout is serious and in order to ensure that nurses are taken care of, the administration must implement incentives and policies that will provide nurses with the resources to maintain a healthy work life balance. Burnout accounts for many of the medication errors and patient injuries in healthcare facilities. Most nurses are overwhelmed because of the caseload and longer workdays necessary to complete charting. Many nurses are also disgruntled because of denied vacation requests that cannot be approved because of non-coverage. Research has shown that when employees are happy then there are less errors and injuries in

Fatigue and sleepiness, tendency to fall asleep, go hand in hand as nurses struggle to stay awake during long, consecutive, day or night shifts. For example, in the Staff Nurse Fatigue and Patient Safety Study, the number of nurses who reported an error or a near miss had less hours of sleep than the nurses who did not report an error or a near miss, and it was determined that there is a 3.4 percent chance of a nursing error when nurses get 6 hours of sleep or less in the prior 24 hours; another study found that the chances of making an error was three times higher when nurses worked more than 12.5 hours per shift (Rogers, 2008). In the Staff Nurse Fatigue and Patient Safety Study, over two thirds of the participants reported that they struggle to stay awake while working and 20 percent reported incidence of falling asleep during their shift (Rogers, 2008). Nurses also do not get adequate breaks while working long shifts, according to the Agency of Healthcare Research and Quality (AHRQ) less than 50% of work breaks for are away from patient care, which means nurses never truly get a chance to relax (Phillips, 2014). Not only is the patient safety at risk when nurses are fatigued, but the well being of nurses is at stake as well. While nurses are fatigued they are risking their

In today’s current fast-paced and demanding field of heath care, medication administration has become complex and time-consuming task. Approximately one-third of the nurses’ time is used in medication administration. There is much potential for error because of the complexity of the medication administration process. Since nurses are the last ones to actually administer the medication to the patient therefore they become responsible for medication administration errors (MAE). Reasons for MAE may include individual factors, organizational factors or system factors. This paper will discuss the root causes analysis of MAE and strategies to prevent them.

The methods used will include conduction of a time study using the Comprehensive List of Potential Clinical Pharmacy Technician (CPT) Tasks to observe a clinical pharmacist completing the tasks for the VAPORHCS ACC on 3 separate days over a 30-day time frame. The 3 oberservation days will occur on different days of the week to present a more accurate assessment of the ACC workflow throughout the week. Pharmacist tasks that are not included in the Comprehensive List will still be documented and tracked. Time study data will include task being completed, start/end time (measured in whole minutes), de-identified individual patient associated with task (only the randomized patient number will be recorded). To account for interruptions when completing a task, the interrupting task will be recorded as a new task line.

This research study is about how nurses administer medications safely or how existing systems facilitate / hinder the medication administration, which has missed the opportunity for the implementation of practical, effective, and low-cost approach to optimize safety. The purpose of the study is to pinpoint factors that facilitate and/or hinder successful medication administration, which targets on three integral parts: nurse practices and workarounds, medication administration workflow, and nature of interruptions and distractions during medication administration. In effect, the findings showed three interrelated themes that facilitated successful medication administration in some situations, but also acted as barriers in others. These interrelated themes include (1) system configurations and features, (2) Behavior types among nurses, and (3) patient interactions. Some system configuration and features acted as physical pressure for parts of the drug round, however, some system effects were partly dependent on nurses ' inherent behavior, which were grouped as: 'task focus ' and 'patient-interaction focused '. The 'task focus ' is a more organized workflow with fewer interruptions, while 'patient-interaction focused ' empowers patients to act as a defense barrier against medication errors by being an active resource of information, a passive resource of information, and/or a 'double-checker '. Thus, researchers concluded that in order to reduce

Managing the variety of interruptions throughout the day as a nurse is one of themain skills that need to be mastered. Inevitably people will want the nurse’s attention formultiple reasons, such as a family member asking for an update on their spouse. If thenurse is in the middle of medication administration, it is critical to communicateeffectively to other staff member, visitors and patients the importance of focusing on themedications given at that time to ensure patient safety. The nurse may need to delegatecertain tasks to other qualified staff members, in order to stay on time with medicationadministration for their patients. Preparing a priority list at the beginning of the shift willhelp organize the nurse’s schedule and be more likely

Medication administration is one nursing task that is considered a high-risk area for patient care (Gladstone, 1995). Studies had shown that “medication errors are the most common and preventable cause of patient harm… and should be immediately reported in order to facilitate the development of a learning culture” (Haw, Stubbs, & Dickens, 2014, p. 797). Thus, a nurse who

To accomplish all of these is to avoid any distraction and interruption during process of administration. To prevent the error, one must double check the order before administration. To have enough staff is another way to prevent rushing and people paying less attention during a patient’s care. Good communication is a crucial in prevention of medication errors. Nurses need a good amount of quiet time to take report at the beginning of