A cluster randomised controlled feasibility study of nurse-initiated behavioural strategies to manage interruptions during medication administration

Objectives
To examine the feasibility of a behavioural e-learning intervention to support nurses to manage interruptions during medication administration.

Design
A cluster randomised feasibility trial.

Setting
The cluster trial included four intervention and four control wards randomly selected across four metropolitan hospitals in Sydney, Australia.

Participants
We observed 806 (402 pre-intervention and 404 post-intervention) medication events, where nurses prepared and administered medications to patients within the cluster wards.

Main Outcome Measures
The primary outcome measured was the observed number of interruptions occurring during administration, with secondary outcomes being the number of clinical errors and procedural failures. Changes in the use of behavioural strategies to manage interruptions, targeted by the e-learning intervention, were also assessed.

Results
No significant differences were found in the number of interruptions (P = 0.82), procedural failures (P = 0.19) or clinical errors per 100 medications (P = 0.32), between the intervention and control wards. Differences in the use of specific behavioural strategies (engagement and multitasking) were found in the intervention wards.

Conclusion
This behavioural e-learning intervention has not been found to significantly reduce interruptions, however, changes in the use of strategies did occur. Careful selection of clinical settings where there is a high number of predictable interruptions is recommended for further research into the impact of the behavioural e-learning intervention. An increase in the intensity of this intervention is recommended with training undertaken away from the clinical setting. Further research on additional consumer-sensitive interventions is urgently needed.