HEALTHCARE
May 7, 2010

Interruptions Behind Many Medication Errors

The more a nurse is interrupted while preparing or administering medication, the greater the chance of error.

A study from the University of Sydney, Australia finds that the more nurses are interrupted while preparing to administer medications, the greater their likelihood of making potentially serious mistakes. The study is published in the April 26th, 2010 issue of the Archives of Internal Medicine.

The more nurses were interrupted while administering a single drug to a patient, the greater the chance of the nurse making a serious mistake.

Johanna I. Westbrook and her team looked at how interruptions affected 98 nurses as they administered over 4,200 medications to some 720 patients over a period of a couple of years. They tracked the number of interruptions the nurses experienced, and looked at how this number related to two variables. The first had to do with problems in the procedure used (for example, not using an aseptic technique, or failing to record the medication used). The second measure tracked clinical errors (such as using the wrong dose of medication, or using the wrong drug, formula, or strength). The team defined an interruption as any external event that caused the nurse to stop what he or she was doing and attend to the other situation.

The researchers found that there was a significant relationship between the number of interruptions a nurse experienced and his or her likelihood of making mistakes, in both of the measures mentioned above. The authors write, “[t]he more interruptions nurses received, the greater the number of errors.” Even more disturbing is the fact that they “found that, as interruptions increased within a single drug administration, the greater the severity of error.” This means that the more nurses were interrupted while administering a single drug to a patient, the greater the chance of the nurse making a serious mistake.

Luckily, most errors (almost 80%) were viewed as clinically “insignificant” by the researchers, meaning they didn’t lead to any real problems for the patient. Only about 2.7% were ranked as major errors, which were defined as leading to potentially permanent problems in body function, a need for surgery as a result, or even death.

This study, according to the authors, is the first to look experimentally at the relationship between the number of interruptions a nurse experiences and the number and severity of errors he or she makes. They add that more research will be needed to understand why nurses experience these sometimes frequent interruptions, and what can be done to avoid the unnecessary ones. Doing so may lead to better patient care, and, in rare cases, better prognosis, in the hospital setting.

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