Interruptions and nursing workload during medication administration process

Rev Bras Enferm. 2019 Aug 19;72(4):1001-1006. doi: 10.1590/0034-7167-2018-0680.
[Article in English, Portuguese]

Abstract

Objective: To investigate the sources and causes of interruptions during the medication administration process performed by a nursing team and measure its frequency, duration and impact on the team's workload.

Métodos: This is an observational study that timed 121 medication rounds (preparation, administration and documentation) performed by 15 nurses and nine nursing technicians in a Neonatal Intensive Care Unit in the countryside of the state of São Paulo.

Resultados: 63 (52.1%) interruptions were observed. In each round, the number of interruptions that happened ranged from 1-7, for 127 in total; these occurred mainly during the preparation phase, 97 (76.4%). The main interruption sources were: nursing staff - 48 (37.8%) - and self-interruptions - 29 (22.8%). The main causes were: information exchanges - 54 (42.5%) - and parallel conversations - 28 (22%). The increase in the mean time ranged from 53.7 to 64.3% (preparation) and from 18.3 to 19.2% (administration) - p≤0.05.

Conclusão: Interruptions in the medication process are frequent, interfere in the workload of the nursing team and may reflect on the safety of care.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Brazil
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intensive Care Units, Neonatal / organization & administration
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Male
  • Medication Errors / nursing
  • Medication Errors / prevention & control
  • Medication Systems / standards*
  • Medication Systems / statistics & numerical data
  • Middle Aged
  • Nursing Care / psychology*
  • Nursing Care / standards*
  • Safety Management / methods
  • Safety Management / standards
  • Safety Management / statistics & numerical data
  • Time Factors
  • Time and Motion Studies
  • Workload / psychology
  • Workload / standards*
  • Workload / statistics & numerical data