Interruptions in the nurse's work and patient safety

Ana Carolina de Oliveira Paiva, Dianna Silva de Oliveira, Marina Aparecida Chrispim Silva, Mariana Almeida Maia, Marilia Alves

Abstract


Objective: to identify the effects of disruptions on the nurse's work routine and patient safety. Method: this is a bibliographical, descriptive, type-integrative review of literature, with the collection of data in the MEDLINE, CINAHL, Web of Science and LILACS databases, in indexed articles from 2013 to 2017, analyzing them in a descriptive way, after the presentation in figures. Results: 17 articles were found and it was noticed that they revealed negative aspects regarding interruption in the nurse's work routine and patient safety, and 76.5% also showed positive points. It should be noted that the results analyzed did not consistently support the negative relationship between the interruptions and their implications in the nurse's work routine and patient safety. Conclusion: aspects that favor the occurrence of interruptions in nurses' practice were evidenced, however, there are few studies that describe the impact of interruptions on the practice and safety of the patient. There is a need for a broad understanding of the factors that cause disruption and jeopardize patient safety. Descriptors: Nursing; Patient Safety; Interruption; Workflow; Nursing Care; Time Management.

RESUMO

Objetivo: identificar os efeitos das interrupções na rotina de trabalho do enfermeiro e na segurança do paciente. Método: trata-se de estudo bibliográfico, descritivo, tipo revisão integrativa de literatura, com a coleta de dados nas bases de dados MEDLINE, CINAHL, Web of Science e LILACS, em artigos indexados de 2013 a 2017, analisando-os de forma descritva, após a apresentação em figuras. Resultados: encontraram-se 17 artigos e se percebeu que revelaram aspectos negativos em relação à interrupção na rotina de trabalho do enfermeiro e na segurança do paciente e 76,5% mostraram, também, pontos positivos. Salienta-se que os resultados analisados não apoiaram consistentemente a relação negativa entre as interrupções e as suas implicações na rotina de trabalho do enfermeiro e na segurança do paciente. Conclusão: evidenciaram-se aspectos que favorecem a ocorrência de interrupções na prática do enfermeiro, entretanto, há poucos estudos que descrevem o impacto das interrupções na prática e na segurança do paciente. Faz-se necessária uma ampla compreensão dos fatores que ocasionam as interrupções e colocam em risco a segurança do paciente. Descritores: Enfermagem; Segurança do Paciente; Interrupção; Fluxo de Trabalho; Cuidados de Enfermagem; Gerenciamento do Tempo.

RESUMEN

Objetivo: identificar los efectos de las interrupciones en la rutina de trabajo del enfermero y en la seguridad del paciente. Método: se trata de un estudio bibliográfico, descriptivo, tipo revisión integradora de literatura, con la recolección de datos en las bases de datos MEDLINE, CINAHL, Web of Science y LILACS, en artículos indexados de 2013 a 2017, analizándolos de manera descriptiva, después de la presentación en figuras. Resultados: se encontraron 17 artículos y se observó que revelaron aspectos negativos relacionados con la interrupción en la rutina de trabajo del enfermero y en la seguridad del paciente, y el 76.5% mostraron también puntos positivos. Cabe señalar que los resultados analizados no apoyaron de manera consistente la relación negativa entre las interrupciones y sus implicaciones en la rutina de trabajo del enfermero y en la seguridad del paciente. Conclusión: se evidenciaron aspectos que favorecen la ocurrencia de interrupciones en la práctica del enfermero, sin embargo, existen pocos estudios que describan el impacto de las interrupciones en la práctica y en la seguridad del paciente. Se hace necesaria una amplia comprensión de los factores que causan las interrupciones y ponen en riesgo la seguridad del paciente. Descriptores: Enfermería; Seguridad del Paciente; Interrupción; Flujo de Trabajo; Atención de Enfermería; Administración del Tiempo.


Keywords


Nursing; Patient Safety; Interruption; Workflow; Nursing Care; Time Management.

References


Organização Mundial da saúde. (OMS). The conceptual framework for the international classification for patient safety. Final Technical Report and Technical Annexes. [Internet]. 2009 [cited 01 Mar 2018]. Available from: http://www.who.int/patientsafety/taxonomy/icps_full_report.pdf

Arruda LP, Gomes EB, Diogo JL, Freitas CHA. Scientific evidences of nursing care about patients’ safety: an integrative review. Rev enferm UFPE on line [internet]. 2014 July [cited 2018 Mar 01];8(7):2107-2114. Doi: 10.5205/reuol.5963-51246-1-RV.0807201436

Reis GAX, Hayakawa LY, Murassak ACY, Matsuda LM, Gabriel CS, Oliveira MLF. Nurse manager perceptions of patient safety strategy implementation. Text Context de enferm. 2017;26(2):3-9. doi:http://dx.doi.org/10.1590/0104-07072017000340016

Monteiro C, Avelar AFM, Pedreira, MLG. Interruptions of nurses' activities and patient safety: an integrative literature review. Rev Latino-Am. Enfermagem. 2015;23(1):169-179. doi:https://doi.org/10.1590/0104-1169.0251.2539

Laustsen S, Brahe L. Applying the Delphi method to generate interventions to reduce unnecessary interruptions in clinical nursing. Nord J Nurs Res. 2015;35(4):249-255. doi:https://doi.org/10.1177/0107408315603630

Berg LM, Källberg AS, Göransson KE, Östergren J, Florin J, Ehrenberg A. Interruptions in emergency department work: an observational and interview study. BMJ Qual Saf. 2013;22:656-663. doi:https://doi.org/bmjqs-2013-001967

Soares CB, Hoga LAK, Peduzzi M, Sangaleti C, Yonekura T, Silva DRAD. Integrative review: concepts and methods used in nursing. Rev Esc Enferm USP. 2014;48(2):335-45. doi:http://dx.doi.org/10.1590/S0080-6234201400002000020

Ferreira DKS, Medeiros SM, Carvalho IM. Psychical distress in nursing worker: an integrative review. Rev Fund Care Online. 2017;9(1):253-258. doi:http://dx.doi.org/10.9789/2175-5361.2017.v9i1.253-258

Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs. 2005; 52(5):546-53. doi:https://doi-org.ez27.periodicos.capes.gov.br/10.1111/j.1365-2648.2005.03621.x

Berg LM, Ehrenberg A, Östergren J, Brixey JJ, Göransson KE. Factors influencing clinicians’ perceptions of interruptions as disturbing or non-disturbing: a qualitative study. Int Emerg Nurs. 2016;27:11-6. doi:https://doi.org/10.1016/j.ienj.2016.01.003

Myres RA, McCarthy MC, Whitlatch A, Parikh PJ. Differentiating between detrimental and beneficial interruptions: a mixed-methods study. BMJ Qual Saf. 2016;25:881-8. doi:https://doi.org/10.1136/bmjqs-2015-004401

Rivera AJ. A socio-technical systems approach to studying interruptions: understanding the interrupter’s perspective. Appl Ergon. 2014;45:747-756. doi:https://doi.org/10.1016/j.apergo.2013.08.009

Berg LM, Florin J, Östergren J, Djärv T, Göransson KE. Reasons for interrupting colleagues during emergency department work - a qualitative study. Int Emerg Nurs. 2016;29:21-6. doi:https://doi.org/10.1016/j.ienj.2016.06.001

Craker NC, Myers RA, Eid J, Parikh P, McCarthy MC, Zink K, et al. Nursing interruptions in a trauma intensive care unit: a prospective observational study. J Nurs Adm. 2017;47(4):205-11. doi:https://doi.org/10.1097/NNA.0000000000000466

Sponner AJ, Corley A, Chaboyer W, Hammond NE, Fraser JF. Measurement of the frequency and source of interruptions occurring during bedside nursing handover in the intensive care unit: an observational study. Aust Crit Care. 2015;28:19-23. doi:https://doi.org/10.1016/j.aucc.2014.04.002

Prates DO, Silva AEBC. Interruptions of activities experienced by nursing professionals in an intensive care unit. Rev Latino-Am. Enfermagem. 2016;24:2-9. doi:https://doi.org/10.1590/1518-8345.0997.2802

Sorensen EE, Brahe L. Interruptions in clinical nursing practice. J Clin Nurs. 2013;23:1274-82. doi:https://doi.org/10.1111/jocn.12329 [included in the review]

Sasangohar F, Donmez B, Easty AC, Trbovich, PL. Effects of nested interruptions on task resumption: a laboratory study with intensive care nurses. Hum Factors. 2017;59(4):628-39. doi:https://doi.org/10.1177/0018720816689513 [included in the review]

Konng AYL, Koot D, Eng SK, Purani A, Goh CC, Teo SS, et al. When the phone rings - factors influencing its impact on the experience of patients and healthcare workers during primary care consultation: a qualitative study. BMC Fam Pract. 2015;16:2-8. doi:https://doi.org/10.1186/s12875-015-0330-x

Cole G, Sterfanus D, Gardner H, Levy MJ, Klein E. The impact of interruptions on the duration of nursing interventions: a direct observation study in an academic emergency department. BMJ Qual Saf. 2016;25:457-65. doi:http://dx.doi.org/10.1136/bmjqs-2014-003683

Elfering A, Nützi M, Koch P, Baur H. Workflow interruptions and failed action regulation in surgery personnel. Saf Health Work. 2014;5:1-6. doi:https://doi.org/10.1016/j.shaw.2013.11.001

Filer HM, Beringuel BL, Frato KM, Anthony MK, Saenyakul P. Interruptions in preanesthesia nursing workflow: a Pilot study of pediatric patient safety. J Perianesth Nurs. 2017;32(2):112-20. doi:https://doi.org/10.1016/j.jopan.2015.01.016

Johnson KD, Motavalli M, Gray D, Kuehn C. Causes and occurrences of interruptions during ED triage. J Emerg Nurs. 2014;40(5):434-9. doi:http://dx.doi.org/10.1016/j.jen.2013.06.019

Sassaki RL, Perroca MG. Interruptions and their effects on the dynamics of the nursing work. Rev Gaúcha Enferm. 2017; 38(2):e67284. doi:http://dx.doi. org/10.1590/1983-1447.2017.02.67284

Dante A, Andrigo I, Barone F, Bonamico R, Chiara A de, Nait M, et al. Occurrence and duration of interruptions during nurses’ work in surgical wards findings from a multicenter observational study. J Nurs Care Qual. 2016; 31(2):174–182. doi:10.1097/NCQ.0000000000000159

Hopkinson SG, Jennings BM. Interruptions during nurses' work: a state-of-the-science review. Res Nurs Health. 2013;36(1):38-53. doi:https://doi.org/10.1002/nur.21515

Klemets J, Evjemo TE. Technology-mediated awareness: facilitating the handling of (un)wanted interruptions in a hospital setting. Int J Med Inform. 2014;83:670-82. doi:https://doi.org/10.1016/j.ijmedinf.2014.06.007

Yoder M, Schadewald D, Dietrich K. The effect of a safe zone on nurse interruptions, distractions, and medication administration errors. J Infus Nurs. 2015;38(2):140-51. doi:https://doi.org/10.1097/NAN.0000000000000095

Dukun N, Zencir G, Eser I. Interruption of the medication preparation process and an examination of factors causing interruptions. J Nurs Manag. 2016;24(3):376-83. doi:https://doi.org/10.1111/jonm.12331

Pape TM. The effect of a five-part intervention to decrease omitted medications. Nurs Forum. 2013;48(3):211-21. doi:https://doi.org/10.1111/nuf.12025

Pereira D, Muller P, Elfering A. Workflow interruptions, social stressors from supervisor(s) and attention failure in surgery personnel. Ind Health. 2015;53(5):427-33. doi:https://doi.org/10.2486/indhealth.2013-0219

Westbrook JI, Li L, Hooper TD, Raban MZ, Middleton S, Lehnbom EC. Effectiveness of a ‘do not interrupt’ bundled intervention to reduce interruptions during medication administration: a cluster randomised controlled feasibility study. BMJ Qual Saf. 2017;0:1-9. Doi:http://dx.doi.org/10.1136/bmjqs-2016-006123




DOI: https://doi.org/10.5205/1981-8963.2019.240082



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