Current status and influencing factors of nursing interruption events

OBJECTIVES To investigate the status of nursing interruption events during medicine administration and to analyze the factors influencing interruptions. STUDY DESIGN The nursing drug delivery process was divided into 3 segments: the processing of doctors' orders, drug allocation, and bedside drug administration. The frequency, source, type, and outcome of interruption events during these 3 segments were observed. The interruption time and medication errors caused by interruptions were analyzed. METHODS The structural observation method was used to observe the 3 steps of the drug delivery process. The observations were performed between 8:30 and 10:30 and between 13:30 and 14:30. Count data are described as frequency, composition ratio, and cumulative percentage. R×C contingency table, t tests, and analysis of variance were used to analyze the data. RESULTS In 270 hours of observation, 3424 nursing interruptions occurred, for a mean of 12.68 interruptions per hour. The mean (SD) interruption time was 28.03 (11.01) seconds, and the total duration of drug administration interruptions was 26.65 hours, accounting for 9.87% of the total observation time. The sources of interruption events were as follows: family members, the environment, doctors, patients, colleagues, the nurses themselves, and others; of these interruptions, 2340 were low-priority events (eg, visitor inquiry, telephone call, consultation, discharge questions), accounting for 68.34%. The incidence of medication errors due to interruptions was 1.139%. CONCLUSIONS Nursing interruption events occur frequently, come from many sources, have complex causes, and commonly lead to negative outcomes. Interruption also has a time cost and can directly lead to medication errors.