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一组旨在减少护士给药过程中干扰和分心情况的干预措施的影响。

The impact of a set of interventions to reduce interruptions and distractions to nurses during medication administration.

作者信息

Relihan Eileen, O'Brien Valerie, O'Hara Sharon, Silke Bernard

机构信息

Medication Safety Office, Chief Executive Offices, St James's Hospital, James's Street, Dublin 8, Ireland.

出版信息

Qual Saf Health Care. 2010 Oct;19(5):e52. doi: 10.1136/qshc.2009.036871. Epub 2010 May 28.

DOI:10.1136/qshc.2009.036871
PMID:20511596
Abstract

OBJECTIVE

To assess the impact of a set of interventions in reducing the interruption/distraction rate during medication administration.

DESIGN AND PARTICIPANTS

Pre- and postintervention observational study of nurses undertaking medication rounds.

SETTING

Acute Medical Admissions Unit (AMAU) of a 1000-bed teaching hospital.

INTERVENTION

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.

MAIN OUTCOME MEASURES

Rate of interruptions and distractions pre- and postintervention overall and for each individual source of interruption.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

设计与参与者

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。

地点

一家拥有1000张床位的教学医院的急性内科收治单元(AMAU)。

干预措施

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。

主要结局指标

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。

结果

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)。

结论

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。

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