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A cluster randomised controlled feasibility study of nurse-initiated behavioural strategies to manage interruptions during medication administration
Maree Johnson Rachel Langdon Tracey Levett-Jones Gabrielle Weidemann Elizabeth Manias Bronwyn Everett
Maree Johnson
Rachel Langdon
Tracey Levett-Jones
Gabrielle Weidemann
Elizabeth Manias
Bronwyn Everett
Abstract
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.
Keywords
experimental research, general methodology, risk management, patient safety, adverse events, practice variations, appropriate healthcare, hospital care, professions, training/education, human resources, medications, intervention, interruptions, behaviour, nursing, cluster trial
Date
2019
Type
Journal article
Journal
International Journal for Quality in Health Care
Book
Volume
31
Issue
8
Page Range
67-73
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled