Reducing interruptions during medication preparation and administration: An improvement project

Alberto Mortaro (Department of Diagnostics and Public Health, University of Verona, Verona, Italy)
Diana Pascu (Department of Medical Board, Ospedale Girolamo Fracastoro, San Bonifacio, Italy)
Serena Pancheri (Department of Diagnostics and Public Health, University of Verona, Verona, Italy)
Mariangela Mazzi (Department of Diagnostics and Public Health, University of Verona, Verona, Italy)
Stefano Tardivo (Department of Diagnostics and Public Health, University of Verona, Verona, Italy)
Claudio Bellamoli (Department of Medical, Ospedale Girolamo Fracastoro, San Bonifacio, Italy)
Federica Ferrarese (Department of Medical, Ospedale Girolamo Fracastoro, San Bonifacio, Italy)
Albino Poli (Department of Diagnostics and Public Health, University of Verona, Verona, Italy)
Gabriele Romano (Department of Diagnostics and Public Health, University of Verona, Verona, Italy)
Francesca Moretti (Department of Diagnostics and Public Health, University of Verona, Verona, Italy)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Publication date: 8 July 2019

Abstract

Purpose

According to literature, interruptions during drug administration lead to a significant proportion of medication errors. Evidence on the effectiveness of interventions to reduce interruption is still limited. The purpose of this paper is to explore main reasons for interruptions during drug administration rounds in a geriatric ward of an Italian secondary hospital and test the effectiveness of a combined intervention.

Design/methodology/approach

This is a pre and post-intervention observational study based on direct observation. All nurse staff (24) participated to the study that lead to observe a total of 44 drug dispensing rounds with 945 drugs administered to 491 patients in T0 and 994 drugs to 506 patients in T1.

Findings

A significant reduction of raw number of interruptions (mean per round from 17.31 in T0 to 9.09 in T1, p<0.01), interruptions/patient rate (from 0.78 in T0 to 0.40 in T1, p<0.01) and interruptions/drugs rate (from 0.44 in T0 to 0.22 in T1, p<0.01) were observed. Needs for further improvements were elicited (e.g. a greater involvement of support staff).

Practical implications

Nurse staff should be adequately trained on the risks related to interruptions during drug administration since routine activity is at high risk of distractions due to its repetitive and skill-based nature.

Originality/value

A strong involvement of both MB and leadership, together with the frontline staff, helped to raise staff motivation and guide a bottom-up approach, able to identify tailored interventions and serve concurrently as training instrument tool.

Keywords

Citation

Mortaro, A., Pascu, D., Pancheri, S., Mazzi, M., Tardivo, S., Bellamoli, C., Ferrarese, F., Poli, A., Romano, G. and Moretti, F. (2019), "Reducing interruptions during medication preparation and administration: An improvement project", International Journal of Health Care Quality Assurance, Vol. 32 No. 6, pp. 941-957. https://doi.org/10.1108/IJHCQA-12-2017-0238

Publisher

:

Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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