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.
journal_name
BMJ Qual Safjournal_title
BMJ quality & safetyauthors
Westbrook JI,Li L,Hooper TD,Raban MZ,Middleton S,Lehnbom ECdoi
10.1136/bmjqs-2016-006123subject
Has Abstractpub_date
2017-09-01 00:00:00pages
734-742issue
9eissn
2044-5415issn
2044-5423pii
bmjqs-2016-006123journal_volume
26pub_type
杂志文章,随机对照试验abstract:IMPORTANCE:There is a paucity of literature on the quality and effectiveness of institutional morbidity & mortality (M&M) rounds processes. OBJECTIVE:We sought to implement and evaluate the effectiveness of a hospital-wide structured M&M rounds model at improving the quality of M&M rounds across multiple specialties. ...
journal_title:BMJ quality & safety
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更新日期:2012-02-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2014-05-01 00:00:00
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更新日期:2018-10-01 00:00:00
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更新日期:2011-07-01 00:00:00
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更新日期:2019-10-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2013-04-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-001734
更新日期:2014-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-05-25 00:00:00
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更新日期:2019-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
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更新日期:2019-12-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,随机对照试验
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更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Insulin is a high-risk medicine which may cause significant patient harm or death when given incorrectly. A 10-fold error in administered insulin dose commonly occurs when the abbreviation 'u' is used for 'units' and subsequently misinterpreted as a 'zero.' METHOD:A multidisciplinary working party was conve...
journal_title:BMJ quality & safety
pub_type: 杂志文章,多中心研究
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更新日期:2011-07-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,随机对照试验
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更新日期:2011-09-01 00:00:00
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journal_title:BMJ quality & safety
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