HumanEra, Techna, University Health Network, Toronto, Ontario, Canada.
J Healthc Eng. 2013;4(1):127-44. doi: 10.1260/2040-2295.4.1.127.
Interruptions are causal factors in medication errors. Although researchers have assessed the nature and frequency of interruptions during medication administration, there has been little focus on understanding their effects during medication ordering. The goal of this research was to examine the nature, frequency, and impact of interruptions on oncologists' ordering practices. Direct observations were conducted at a Canadian cancer treatment facility to (1) document the nature, frequency, and timing of interruptions during medication ordering, and (2) quantify the use of coping mechanisms by oncologists. On average, oncologists were interrupted 17 % of their time, and were frequently interrupted during safety-critical stages of medication ordering. When confronted with interruptions, oncologists engaged/multitasked more often than resorting to deferring/blocking. While some interruptions are necessary forms of communication, efforts must be made to reduce unnecessary interruptions during safety-critical tasks, and to develop interventions that increase oncologists' resiliency to inevitable interruptions.
中断是导致用药错误的原因之一。尽管研究人员已经评估了用药过程中中断的性质和频率,但很少关注理解中断对用药医嘱过程的影响。这项研究的目的是检查中断的性质、频率和对肿瘤医生医嘱实践的影响。在加拿大癌症治疗中心进行了直接观察,以记录(1)用药医嘱过程中中断的性质、频率和时间安排,以及(2)量化肿瘤医生使用应对机制的情况。平均而言,肿瘤医生会被中断 17%的时间,并且在用药医嘱的安全关键阶段经常被中断。当面临中断时,肿瘤医生更多地参与/多任务处理,而不是推迟/阻止。虽然有些中断是必要的沟通形式,但必须努力减少安全关键任务中的不必要中断,并开发干预措施,以提高肿瘤医生对不可避免中断的适应能力。