Nurses administering medications can’t pardon the interruption


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Nurses are busy, busy people. If you’re a patient, you can help the nurse do his or her job by keeping mum when they are conducting important tasks. A study published Monday found that nurses make more medication errors when they are interrupted during the task.

Interruptions are known to increase on-the-job mistakes. But the researchers, from Australia, sought to understand the impact of interruptions on nurses. They observed 98 hospital-based nurses over 505 hours. The nurses administered a total of 4,271 medications during those hours. Only 19.8% of these administrations were free of two kinds of errors: procedural mistakes, such as failure to read labels or check patient identification; and clinical errors, such as administering the wrong drug, dose or formulation.


However, interruptions occurred in 53% of all administrations. When nurses were not interrupted, procedural failure rates were 69.6% and clinical error rates were 25.3%. When they were interrupted three times, the rates went up to 84.6% for procedural errors and 38.9% for clinical errors. The errors became more severe the more times the nurse was interrupted during the task.

Some interruptions, such as tending to a monitor alarm, are necessary. But the study found that only 11% of the interruptions were positive. ‘While it is clear that some interruptions are central to providing safe care, there is a need to better understand the reasons for such high interruption rates,’ the authors wrote.

‘The frequency of interruptions during medication administration suggests a lack of understanding of the importance of this process and of the deleterious effects of interruptions on patient safety,’ Julie Kliger, of the Integrated Nurse Leadership Program at UC San Francisco, wrote in an editorial accompanying the study. ‘Perhaps more significantly, it alerts us to a widespread lack of respect for the medication administration process.’

The study was released Monday in the Archives of Internal Medicine.

-- Shari Roan