The impact of a set of interventions to reduce interruptions and distractions to nurses during medication administration

Objective To assess the impact of a set of interventions in reducing the interruption/distraction rate during medication administration. Design and participants Pre- and postintervention observational study of nurses undertaking medication rounds. Setting Acute Medical Admissions Unit (AMAU) of a 1000-bed teaching hospital. Intervention A set of measures previously proven successful in reducing interruptions (behaviour modification and staff education; checklists; visible symbols in the form of a red vest; and signage) were adapted and introduced onto the AMAU. Main outcome measures Rate of interruptions and distractions pre- and postintervention overall and for each individual source of interruption. Results There was a highly significant association (p<0.0001) between the overall interruption/distraction rate and the pre-/postintervention studies, with the rate of interruptions postintervention being 0.43 times that of the preintervention level. When individual sources of interruptions and distractions were compared pre- and postintervention, a significant difference (p<0.05) in the interruption/distraction rate was found for five of the 11 categories assessed. Conclusions The data support a multifactorial approach to reducing the interruption/distraction rate on medication rounds. Suggestions for future research include: directly quantifying the impact of the interventions described in this study on the volume of medication administration errors; assessing the time lost as a result of interruptions and distractions during the medication round; and developing a standardised means of recording and analysing interruptions and distractions to allow meaningful comparison of the benefits of interventions across studies.