Relihan Eileen, O'Brien Valerie, O'Hara Sharon, Silke Bernard
Medication Safety Office, Chief Executive Offices, St James's Hospital, James's Street, Dublin 8, Ireland.
Qual Saf Health Care. 2010 Oct;19(5):e52. doi: 10.1136/qshc.2009.036871. Epub 2010 May 28.
To assess the impact of a set of interventions in reducing the interruption/distraction rate during medication administration.
Pre- and postintervention observational study of nurses undertaking medication rounds.
Acute Medical Admissions Unit (AMAU) of a 1000-bed teaching hospital.
A set of measures previously proven successful in reducing interruptions (behaviour modification and staff education; checklists; visible symbols in the form of a red vest; and signage) were adapted and introduced onto the AMAU.
Rate of interruptions and distractions pre- and postintervention overall and for each individual source of interruption.
There was a highly significant association (p<0.0001) between the overall interruption/distraction rate and the pre-/postintervention studies, with the rate of interruptions postintervention being 0.43 times that of the preintervention level. When individual sources of interruptions and distractions were compared pre- and postintervention, a significant difference (p<0.05) in the interruption/distraction rate was found for five of the 11 categories assessed.
The data support a multifactorial approach to reducing the interruption/distraction rate on medication rounds. Suggestions for future research include: directly quantifying the impact of the interventions described in this study on the volume of medication administration errors; assessing the time lost as a result of interruptions and distractions during the medication round; and developing a standardised means of recording and analysing interruptions and distractions to allow meaningful comparison of the benefits of interventions across studies.
评估一系列干预措施对降低给药过程中干扰/分心率的影响。
对进行药物查房的护士开展干预前和干预后的观察性研究。
一家拥有1000张床位的教学医院的急性内科收治单元(AMAU)。
对一组先前已证明在减少干扰方面成功的措施(行为改变和员工教育;检查表;红色背心形式的可见标识;以及 signage)进行调整并引入到AMAU。
干预前和干预后总体以及每种单独干扰源的干扰和分心率。
总体干扰/分心率与干预前/后研究之间存在高度显著关联(p<0.0001),干预后的干扰率是干预前水平的0.43倍。在比较干预前和干预后单独的干扰和分心源时,在所评估的11个类别中的5个类别中发现干扰/分心率存在显著差异(p<0.05)。
数据支持采用多因素方法来降低药物查房时的干扰/分心率。对未来研究的建议包括:直接量化本研究中所述干预措施对给药错误数量的影响;评估因药物查房期间的干扰和分心而损失的时间;以及开发一种标准化的记录和分析干扰和分心的方法,以便能够对不同研究中干预措施的益处进行有意义的比较。