Excuse Me! Interruptions Experienced by Registered Nurses Working in the Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/162530
Type:
Presentation
Title:
Excuse Me! Interruptions Experienced by Registered Nurses Working in the Emergency Department
Abstract:
Excuse Me! Interruptions Experienced by Registered Nurses Working in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Kosits, Lisa, DNP, RN-BC, CCRN, CEN
P.I. Institution Name:Montefiore Medical Center
Title:Clinical Faculty
Contact Address:111 East 210th Street, Bronx, NY, 10467, USA
Contact Telephone:718-920-5241
[Annual Conference Research Poster]
Purpose: The second most common sentinel event in hospital EDs is medication error. Common risk factors associated with medication errors in the ED include frequent distractions and interruptions.
The specific research questions for the study were as follows:
1) How many interruptions per hour does a typical ED nurse experience?
2) What are the types of interruptions an ED nurse experiences?
3) What percentage of the interruptions takes place during medication preparation, administration, or documentation, thus increasing the chances of committing a medication error?
Design: The design of the study was a prospective descriptive and observational study.

Setting: Three academic level II trauma emergency departments in a large metropolitan area in the northeast were utilized.

Sample: A convenience sample of 30 RNs was utilized- ten from each ED. Inclusion criteria were all RNs working in the three EDs of the healthcare system. RNs on orientation, RNs acting as a preceptor and the Charge Nurse were excluded because they may experience different types of interruptions based on their teacher-learner and leadership roles.
For the protection of human subjects, IRB approval was obtained from the studies healthcare system. Participation was voluntary and a consent process was initiated on all subjects.

Methodology: The observations occurred over a continuous 120-minute period. Enrollment and data collection occurred over a three-week period. The investigator collected demographic data about the nurse (gender, age, years of nursing experience, and years of ED nursing experience) and the department (shift, number of RNs on duty, number of patients in the ED at the beginning and end of the observation, number of patients assigned to the nurse and acuity of the patients assigned). No identifying patient information was collected.
An Interruptions Data Collection Tool was developed to measure the number and type of interruptions, along with the task being performed at the time of the interruption. Reliability was determined by interrater method. Five experts in the field of emergency nursing were chosen to review the categories for validity and observational sampling was performed which validated the list developed.
Notations were made on the data collection form each time an interruption occurred including the type of interruption and task being interrupted. An interruption was defined as any event that caused a break in performing a task for 10 seconds or more.

Results: Mean number of interruptions was 3.3 per hour. The most frequent types of interruptions included face-to-face communications with: RNs (42%); MDs (28.5%); family (8%); and technicians (6%). The greatest number of interruptions occurred during documentation in the patient's medical record (37%) followed by medication related activities (27.5%).

Conclusions: The study provides seminal information on the frequency of interruptions in the ED. Subsequent investigations may build on these study results to determine the association between specific interruptions and subsequent adverse events and patient outcomes. This in turn will lead to development and implementation of interventions to reduce the error rate in EDs.

Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleExcuse Me! Interruptions Experienced by Registered Nurses Working in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162530-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Excuse Me! Interruptions Experienced by Registered Nurses Working in the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kosits, Lisa, DNP, RN-BC, CCRN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Montefiore Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Faculty</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">111 East 210th Street, Bronx, NY, 10467, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">718-920-5241</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lkosits@montefiore.org</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference Research Poster] <br/>Purpose: The second most common sentinel event in hospital EDs is medication error. Common risk factors associated with medication errors in the ED include frequent distractions and interruptions. <br/>The specific research questions for the study were as follows: <br/>1) How many interruptions per hour does a typical ED nurse experience?<br/>2) What are the types of interruptions an ED nurse experiences?<br/>3) What percentage of the interruptions takes place during medication preparation, administration, or documentation, thus increasing the chances of committing a medication error?<br/>Design: The design of the study was a prospective descriptive and observational study.<br/><br/>Setting: Three academic level II trauma emergency departments in a large metropolitan area in the northeast were utilized.<br/><br/>Sample: A convenience sample of 30 RNs was utilized- ten from each ED. Inclusion criteria were all RNs working in the three EDs of the healthcare system. RNs on orientation, RNs acting as a preceptor and the Charge Nurse were excluded because they may experience different types of interruptions based on their teacher-learner and leadership roles. <br/> For the protection of human subjects, IRB approval was obtained from the studies healthcare system. Participation was voluntary and a consent process was initiated on all subjects.<br/><br/>Methodology: The observations occurred over a continuous 120-minute period. Enrollment and data collection occurred over a three-week period. The investigator collected demographic data about the nurse (gender, age, years of nursing experience, and years of ED nursing experience) and the department (shift, number of RNs on duty, number of patients in the ED at the beginning and end of the observation, number of patients assigned to the nurse and acuity of the patients assigned). No identifying patient information was collected. <br/>An Interruptions Data Collection Tool was developed to measure the number and type of interruptions, along with the task being performed at the time of the interruption. Reliability was determined by interrater method. Five experts in the field of emergency nursing were chosen to review the categories for validity and observational sampling was performed which validated the list developed.<br/> Notations were made on the data collection form each time an interruption occurred including the type of interruption and task being interrupted. An interruption was defined as any event that caused a break in performing a task for 10 seconds or more. <br/><br/>Results: Mean number of interruptions was 3.3 per hour. The most frequent types of interruptions included face-to-face communications with: RNs (42%); MDs (28.5%); family (8%); and technicians (6%). The greatest number of interruptions occurred during documentation in the patient's medical record (37%) followed by medication related activities (27.5%).<br/><br/>Conclusions: The study provides seminal information on the frequency of interruptions in the ED. Subsequent investigations may build on these study results to determine the association between specific interruptions and subsequent adverse events and patient outcomes. This in turn will lead to development and implementation of interventions to reduce the error rate in EDs.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:45Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:45Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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