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DOI: 10.1101/2023.05.17.23290098

Investigation of a Behavioral Interruption Management Strategy on Improving Medication Administration Safety and Efficiency: A Feasibility Study

G.Schroers J. Pfieffer D. Tell J. O'Rourke
Background: Worldwide, interruptions are pervasive during nurse medication administration and associated with increased frequency and severity of errors. Interruptions also decrease task efficiency which can lead to delayed or omitted patient care. Interruptions cannot always be avoided in healthcare settings; thus, researchers recommend the use of interruption management strategies to mitigate interruptions' negative effects. Aims: To investigate the feasibility and potential of a behavioral interruption management strategy to mitigate medication errors and improve task efficiency. Design: Multi-methods, two groups, repeated measures, pre-posttest design. Methods: Data were collected January-March 2023. Volunteer undergraduate nursing students were randomly assigned to a control or intervention group. The intervention group received education and training on an interruption management strategy. Quantitative data were collected across three timepoints via direct observation of independent demonstrations of simulated medication administration. The simulated scenarios contained embedded interruptions. Outcomes measured included errors, medication preparation duration, and duration of time to implement the interruption management strategy. Descriptive statistics were analyzed using Microsoft Excel. Qualitative data of participants' perceptions and use of the strategy were collected via semi-structured interviews. Thematic analysis was performed. Reporting Method: Equator guidelines were followed using the STROBE reporting method for the observed quantitative data. SRQR guidelines were followed in reporting the qualitative data. Results: Nineteen students participated in the study. Intervention group participants had larger improvements in errors and task durations compared to the control group. Implementation of the strategy averaged four seconds. Participants described the strategy as easy to use and remember, and voiced using the strategy outside of the study. Conclusions: Findings demonstrate that the study-described behavioral interruption management strategy was feasible to teach and implement, and associated with decreased errors and improved task efficiency. Use of the strategy has implications to increase patient safety through improved medication administration safety and efficiency. Future studies are recommended to gain a better understanding of the strategy's effectiveness.