The effect of nurses' use of a focused protocol to decrease distractions during medication administration

Date
2002-05-30
Authors
Pape, Theresa
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Abstract

Medication administration errors (MAE) are often the result of system problems that lead to patient injury, increased hospital costs and nurses being blamed for the incident. Contributing factors include distractions, lack of focus, poor communication, and failure to follow standard operating procedures during medication administration. A quasi-experimental study was conducted to measure the effect of two targeted interventions based on airline industry safety measures for decreasing nurses' distractions during medication administration. The study was conducted at a mid-sized acute care "for profit" hospital in a large southeastern metropolitan city in Texas. A convenience sample of 24 medication administration cycles was observed during high volume medication administration times. Observed nurses were LVNs and RNs who routinely administer medications. The study involved three groups with nurses in the control group using customary medication administration procedures. Nurses in the first intervention group used the focused protocol. The third group used the Medsafe© protocol intervention with the same instruction, teamwork, and checklist, but a]so wore a special vest to indicate to others that distractions were not acceptable during medication administration. Two instruments were used during the study: the Demographic Data Form (DDF) and the Medication Administration Distraction Observation Sheet (MADOS). The MADOS was validated using Fehring's Diagnostic Content Validity Model. The ANOVA (alpha= .05) revealed significance among groups, F (2, 23) = 68.229, p = .000. Post hoc pairwise comparisons using Tukey's HSD revealed significance between the control and focused protocol groups 12. = .000, between the focused protocol and Medsafe© groups, p = .014, and between the control and Medsafe© protocol groups, p = .000. Multiple regression revealed all 10 distraction predictors as significant for causing distractions, R2 = 1.0, F (10, 13) = 2.96E + 15, p = .000. Bivariate linear regression showed conversation (r2 = .93), personnel interrupting (r2 = .90), and noises (r2 = .87) were highly related to total distractions experienced. Study results infer that changes in work design using teamwork and targeted interventions can significantly reduce nurses' distractions during medication administration, ultimately reducing medication errors.

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Keywords
Drugs, Nursing, Nurse and patient, Medication administration, Distractions
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