The Effectiveness of Interventions to Reduce the Nurses' Distractions during Medication Administration: A Systematic Review
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Introduction:Nurses constitute the largest group of health professionals who work in the hospital setting and most of the medications in the setting are administered by nurses. Errors related to medication conducted by a nurse frequently occur during medication administration. Interruptions or distractions during medication administration have been identified as significant contributory factors to medication administration errors (MAEs).
Methods: This systematic review critically reviewed the evidence of the effectiveness of the interventions that aim to reduce nurse interruptions or distractions during medication administration. The search for the relevant literature was conducted in August 2018 using three databases; Medline, Cinahl and Embase.
Results: Nineteen full text articles were retrieved and reviewed, and 7 articles were included in this review. Five of these studies showed evidence of a reduction in the interruption or distraction rates in post-intervention measurements, while 4 studies reported a statistically significant reduction in the interruption or distraction rates, with p values between 0.0005 and 0.002.
Conclusion: There was limited evidence available to support the effectiveness of the interventions in terms of either reducing the interruptions or distractions of the nurses during the medication administration or in terms of reducing the medication administration error rates.Aguirre, T., Wilhelm, S., Backer, S., Schoeneman, S., & Koehler, A. (2015). Medication Administration Interruptions in a Rural Hospital and Evaluation of a Red Light Intervention. Online Journal of Rural Nursing and Health Care. https://doi.org/10.14574/ojrnhc.v15i2.327
Anthony, K., Wiencek, C., Bauer, C., Daly, B., & Anthony, M. K. (2010). Safety in intensive care units no interruptions please: Impact of a no interruption zone on medication. Critical Care Nurse. https://doi.org/10.4037/ccn2010473
Australian Commission on Safety and Quality in Health Care. (2012). National Safety and Quality Health Service Standards.
Biron, A. D., Loiselle, C. G., & Lavoie-Tremblay, M. (2009). Work interruptions and their contribution to medication administration errors: An evidence Review. Worldviews on Evidence-Based Nursing. https://doi.org/10.1111/j.1741-6787.2009.00151.x
Ching, J. M., Long, C., Williams, B. L., & Blackmore, C. C. (2013). Using lean to improve medication administration safety: In search of the "perfect dose.” Joint Commission Journal on Quality and Patient Safety. https://doi.org/10.1016/s1553-7250(13)39026-6
Colligan, L., & Bass, E. J. (2012). Interruption handling strategies during paediatric medication administration. BMJ Quality and Safety. https://doi.org/10.1136/bmjqs-2011-000292
Conrad, C., Fields, W., McNamara, T., Cone, M., & Atkins, P. (2010). Medication room madness: Calming the chaos. Journal of Nursing Care Quality. https://doi.org/10.1097/NCQ.0b013e3181c3695d
Dall'Oglio, I., Fiori, M., Di Ciommo, V., Tiozzo, E., Mascolo, R., Bianchi, N., ... Raponi, M. (2017). Effectiveness of an improvement programme to prevent interruptions during medication administration in a paediatric hospital: A preintervention-postintervention study. BMJ Open. https://doi.org/10.1136/bmjopen-2016-013285
Flynn, F., Evanish, J. Q., Fernald, J. M., Hutchinson, D. E., & Lefaiver, C. (2016). Progressive care nurses improving patient safety by limiting interruptions during medication administration. Critical Care Nurse. https://doi.org/10.4037/ccn2016498
Goodwin, M. A., Stange, K. C., Zyzanski, S. J., Crabtree, B. F., Borawski, E. A., & Flocke, S. A. (2017). The Hawthorne effect in direct observation research with physicians and patients. Journal of Evaluation in Clinical Practice. https://doi.org/10.1111/jep.12781
Gorini, A., & Pravettoni, G. (2013). Nurses' violations of a medication administration protocol in Italy: an observational study. Clinical Nursing Studies. https://doi.org/10.5430/cns.v1n2p80
Grundgeiger, T., & Sanderson, P. (2009). Interruptions in healthcare: Theoretical views. International Journal of Medical Informatics. https://doi.org/10.1016/j.ijmedinf.2008.10.001
Hayes, C., Jackson, D., Davidson, P. M., & Power, T. (2015). Medication errors in hospitals: A literature review of disruptions to nursing practice during medication administration. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.12944
Hopkinson, S. G., & Jennings, B. M. (2013). Interruptions during nurses' work: A state-of-the-science review. Research in Nursing and Health. https://doi.org/10.1002/nur.21515
Ingham-Broomfield, R. J. (2016). A nurses' guide to the hierarchy of research designs and evidence. Australian Journal of Advanced Nursing.
Joint Commission on Accreditation of Healthcare Organizations. (2013). Joint Commission International accreditation standards for hospitals. Joint Commission Resources.
KARS. (2017). Standar Nasional Akreditasi Rumah Sakit Efektif 1 Januari 2018. Standar Nasional Akreditasi Rumah Sakit.
Katz, M. H. (2010). Evaluating clinical and public health interventions: A practical guide to study design and statistics. Evaluating Clinical and Public Health Interventions: A Practical Guide to Study Design and Statistics. https://doi.org/10.1017/CBO9780511712074
Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013). Prevalence and nature of medication administration errors in health care settings: A systematic review of direct observational evidence. Annals of Pharmacotherapy. https://doi.org/10.1345/aph.1R147
Mahmood, A., Chaudhury, H., & Valente, M. (2011). Nurses' perceptions of how physical environment affects medication errors in acute care settings. Applied Nursing Research. https://doi.org/10.1016/j.apnr.2009.08.005
Muñoz, A. B. J., Miguez, A. M., Pérez, M. P. R., Escribano, M. D. V., Garcia, M. E. D., & Saez, M. S. (2010). Medication error prevalence. International Journal of Health Care Quality Assurance. https://doi.org/10.1108/09526861011029389
Murad, M. H., Asi, N., Alsawas, M., & Alahdab, F. (2016). New evidence pyramid. Evidence-Based Medicine. https://doi.org/10.1136/ebmed-2016-110401
Olsen, L. A., Goolsby, W. A., & McGinnis, J. M. (2009). Leadership commitments to improve value in health care: Finding common ground: Workshop summary. Leadership Commitments to Improve Value in Health Care: Finding Common Ground: Workshop Summary. https://doi.org/10.17226/11982
Pape, T. M. (2013). The effect of a five-part intervention to decrease omitted medications. Nursing Forum. https://doi.org/10.1111/nuf.12025
Picone, D. M., Titler, M. G., Dochterman, J., Shever, L., Kim, T., Abramowitz, P., ... Qin, R. (2008). Predictors of medication errors among elderly hospitalized patients. American Journal of Medical Quality. https://doi.org/10.1177/1062860607313143
Polit D F and Beck C T. (2018). Essentials of nursing research : appraising evidence for nursing practice.
Raban, M. Z., & Westbrook, J. I. (2014). Are interventions to reduce interruptions and errors during medication administration effective?: A systematic review. BMJ Quality and Safety. https://doi.org/10.1136/bmjqs-2013-002118
Reid-Searl, K., & Happell, B. (2012). Supervising nursing students administering medication: A perspective from registered nurses. Journal of Clinical Nursing. https://doi.org/10.1111/j.1365-2702.2011.03976.x
Relihan, E., O'Brien, V., O'Hara, S., & Silke, B. (2010). The impact of a set of interventions to reduce interruptions and distractions to nurses during medication administration. Quality and Safety in Health Care. https://doi.org/10.1136/qshc.2009.036871
Roughead, E. E., & Semple, S. J. (2009). Medication safety in acute care in Australia: Where are we now? Part 1: A review of the extent and causes of medication problems 2002-2008. Australia and New Zealand Health Policy. https://doi.org/10.1186/1743-8462-6-18
Roughead, E. E., Semple, S. J., & Rosenfeld, E. (2016). The extent of medication errors and adverse drug reactions throughout the patient journey in acute care in Australia. International Journal of Evidence-Based Healthcare. https://doi.org/10.1097/XEB.0000000000000075
Slife, B. D., Wright, C. D., & Yanchar, S. C. (2016). Using operational definitions in research: A best-practices approach. Journal of Mind and Behavior.
Stein, J. E., & Heiss, K. (2015). The Swiss cheese model of adverse event occurrence-Closing the holes. Seminars in Pediatric Surgery. https://doi.org/10.1053/j.sempedsurg.2015.08.003
Strategies to reduce medication errors with reference to older adults. (2006, June). Nursing Standard (Royal College of Nursing (Great Britain) : 1987). https://doi.org/10.7748/ns.20.41.53.s60
Tomietto, M., Sartor, A., Mazzocoli, E., & Palese, A. (2012). Paradoxical effects of a hospital-based, multi-intervention programme aimed at reducing medication round interruptions. Journal of Nursing Management. https://doi.org/10.1111/j.1365-2834.2012.01329.x
Velo, G. P., & Minuz, P. (2009). Medication errors: Prescribing faults and prescription errors. British Journal of Clinical Pharmacology. https://doi.org/10.1111/j.1365-2125.2009.03425.x
Westbrook, J. I., Li, L., Hooper, T. D., Raban, M. Z., Middleton, S., & Lehnbom, E. C. (2017). Effectiveness of a Do not interrupt' bundled intervention to reduce interruptions during medication administration: A cluster randomised controlled feasibility study. BMJ Quality and Safety. https://doi.org/10.1136/bmjqs-2016-006123
WHO. (2009). Patient Safety Curricullum Guide for Medical School.
WHO. (2018). Patient Safety: Data and Statistic.
Williams, T., King, M. W., Thompson, J. A., & Champagne, M. T. (2014). Implementing Evidence-Based Medication Safety Interventions on a Progressive Care Unit. AJN, American Journal of Nursing. https://doi.org/10.1097/01.naj.0000456433.07343.7f
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