Schutijser, B.C.F.M., Klopotowska, J.E., Jongerden, I.P., Spreeuwenberg, P.M.M., Bruijne, M.C. de, Wagner, C.
Interruptions during intravenous medication administration: a multicenter observational study.
Journal of Advanced Nursing, (2018) ,
Aims:
To determine the frequency and cause of interruptions during intravenous medication administration, which factors are associated with interruptions and to what extent interruptions influence protocol compliance.

Background:
Hospital nurses are frequently interrupted during medication administration, which contributes to the occurrence of administration errors. Errors with intravenous medication are especially worrisome, given their immediate therapeutic effects. However, knowledge about the extent and type of interruptions during intravenous medication administration is limited.

Design:
Multicenter observational study.

Methods:
Data were collected during two national evaluation studies (2011/2012 and 2015/2016). Nurses were directly observed during intravenous medication administration. An interruption was defined as a situation where a break during the administration was needed or where a nurse was distracted but could process without a break. Interruptions were categorized according to source and cause. Multilevel logistic regression analyses were conducted to assess the associations between explanatory variables and interruptions or complete protocol compliance.

Results:
In total, 2526 intravenous medication administration processes were observed. During 291 (12%) observations, nurses were interrupted 321 times. Most interruptions were externally initiated by other nurses (19%) or patients (19%). Less interruptions occurred during the evening (Odds Ratio: 0.23, (95%‐Confidence Interval: 0.08‐0.62). Do‐not‐disturb vests were worn by 61 (2%) nurses. No significant association was found between being interrupted and complete protocol compliance.

Conclusion:
An interruption occurred in every eight observed intravenous medication administration, mainly caused by other nurses or patients. One needs to critically consider which strategies effectively improve safety during the high‐risk nursing‐task of intravenous medication administration. (aut. ref.)