Interruptions and distractions of nurses during medication administration on a medical surgical unit

Abstract

Medication error is one of the most common preventable problems in the United States medical system today (IOM, 2006). In 2006 the Institute of Medicine recommended there should be "research effort aimed at learning more about preventing medication errors" (p. 3). One way to achieve this goal is to better understand what contributes to medication errors during administration. Many medication administration errors are a direct result of "imperfections in the work system, work assignation, staff understanding and the working conditions" (Buchini & Quattrin, 2012, p. 327). Research shows identification of interruptions or distractions can reduce medication administration errors. Understanding interruptions and distractions create a body of knowledge for policy for future quality improvement. The purpose of this project was to identify interruption trends during medication administration among nursing personnel on one medical-surgical unit in a hospital in Montana. In order to better understand the process surrounding medication administration as well as timing and possible distractions or interruptions, a descriptive observational design was used. Twenty-two nurses on a medical surgical unit were observed during 74 medication passes. Distractions and interruptions during the process were recorded at eight different time periods. Findings of this study did not indicate one single variable was significantly responsible for distractions or interruptions. Rather, the data identified a model which helped explain over 73% the time it took to complete medication administration. Distractions and interruptions of; face-to-face, medication issues, other, equipment, and pagers all contributed. The only variable not contributing to the time equation was noise experienced by the nurse during the medication process. Creating policy to address the variables that interfere with medication administration could decrease interruptions and distractions. The ultimate goal was to create a standard medication administration process for enhanced efficiency, quality and patient safety.