Effectiveness of a ‘do not interrupt’ bundled intervention to reduce interruptions during medication administration : A cluster randomised controlled feasibility study
Journal article
Westbrook, Johanna I., Li, Ling, Hooper, Tamara D., Raban, Magda Z., Middleton, Sandy and Lehnbom, Elin C.. (2017). Effectiveness of a ‘do not interrupt’ bundled intervention to reduce interruptions during medication administration : A cluster randomised controlled feasibility study. BMJ Quality and Safety. 26(9), pp. 734-742. https://doi.org/10.1136/bmjqs-2016-006123
Authors | Westbrook, Johanna I., Li, Ling, Hooper, Tamara D., Raban, Magda Z., Middleton, Sandy and Lehnbom, Elin C. |
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Abstract | Aim To evaluate the effectiveness of a ‘Do not interrupt’ bundled intervention to reduce non-medication-related interruptions to nurses during medication administration. Methods A parallel eight cluster randomised controlled study was conducted in a major teaching hospital in Adelaide, Australia. Four wards were randomised to the intervention which comprised wearing a vest when administering medications; strategies for diverting interruptions; clinician and patient education; and reminders. Control wards were blinded to the intervention. Structured direct observations of medication administration processes were conducted. The primary outcome was non-medication-related interruptions during individual medication dose administrations. The secondary outcomes were total interruption and multitasking rates. A survey of nurses' experiences was administered. Results Over 8 weeks and 364.7 hours, 227 nurses were observed administering 4781 medications. At baseline, nurses experienced 57 interruptions/100 administrations, 87.9% were unrelated to the medication task being observed. Intervention wards experienced a significant reduction in non-medication-related interruptions from 50/100 administrations (95% CI 45 to 55) to 34/100 (95% CI 30 to 38). Controlling for clustering, ward type and medication route showed a significant reduction of 15 non-medication-related interruptions/100 administrations compared with control wards. A total of 88 nurses (38.8%) completed the poststudy survey. Intervention ward nurses reported that vests were time consuming, cumbersome and hot. Only 48% indicated that they would support the intervention becoming hospital policy. Discussion Nurses experienced a high rate of interruptions. Few were related to the medication task, demonstrating considerable scope to reduce unnecessary interruptions. While the intervention was associated with a statistically significant decline in non-medication-related interruptions, the magnitude of this reduction and its likely impact on error rates should be considered, relative to the effectiveness of alternate interventions, associated costs, likely acceptability and long-term sustainability of such interventions. |
Year | 2017 |
Journal | BMJ Quality and Safety |
Journal citation | 26 (9), pp. 734-742 |
Publisher | BMJ Publishing Group |
ISSN | 2044-5415 |
Digital Object Identifier (DOI) | https://doi.org/10.1136/bmjqs-2016-006123 |
PubMed ID | 28232390 |
Scopus EID | 2-s2.0-85029952441 |
PubMed Central ID | PMC5574391 |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 734-742 |
Funder | National Health and Medical Research Council (NHMRC) |
Research Group | Nursing Research Institute |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 23 Feb 2017 |
Publication process dates | |
Accepted | 05 Feb 2017 |
Grant ID | NHMRC/1054146 |
https://acuresearchbank.acu.edu.au/item/855qw/effectiveness-of-a-do-not-interrupt-bundled-intervention-to-reduce-interruptions-during-medication-administration-a-cluster-randomised-controlled-feasibility-study
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Publisher's version
OA_Westbrook_2017_Effectiveness_of_a_Do_not_interrupt.pdf | |
License: CC BY-NC 4.0 | |
File access level: Open |
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