Nurses’ responses to interruptions during medication tasks: A time and motion study

Abstract Background The majority of interruption research has focused on the undesirable effects of interruptions, especially related to errors during medication tasks. However, there may be times when interruptions result in positive effects by providing new information to a situation or preventing an error. The study of nurses' responses to interruptions is limited. Since interruptions cannot (and possibly should not) be avoided, a reasonable method for handling interruptions might be to learn how best to prepare for and manage interruption-prone situations. Objectives The purpose of this study was to examine nurses' responses to interruptions and explore contextual factors that influence interruption management during medication tasks. This is a secondary analysis of an original study aimed at describing interruptions and nurses' responses to interruptions during routine nursing work on medical-surgical units. Design and setting This descriptive study was conducted in 5 medical and/or surgical units at 2 acute care facilities in the southern United States, during weekday shifts. Participants Twenty registered nurses participated in the study. Methods The researcher observed nurse participants for at least 4.5 h during routine nursing work. Observation data were collected using time and motion software. Questionnaires were used to collect organizational, unit, and nurse level data. Interruptions during medication tasks were isolated and described as a secondary analysis. Results Approximately 39% of medication tasks were interrupted. Following an interruption, nurses were more likely to suspend the medication task to attend to the interruption task (51.1%) or multitask (40.3%) than delay responding to the interruption until the medication task was complete (12.6%). Several characteristics of the interruption task, including task type, source, method, and communication intent were associated with nurses' responses at the level of statistical significance. Conclusions The findings of this study reveal that nurses are interrupted frequently during medication tasks. The range of nurses' responses to interruptions was surprising in relation to the frequency with which nurses accepted the interruption task and the infrequency of delay responses. Additional study of nurses' responses to interruptions during medication tasks and the effect of different responses on patient safety outcomes is indicated.