A cluster randomised controlled feasibility study of nurse-initiated behavioural strategies to manage interruptions during medication administration

Johnson, Maree, Langdon, Rachel, Levett-Jones, Tracy, Weidemann, Gabrielle, Manias, Elizabeth and Everett, Bronwyn 2019, A cluster randomised controlled feasibility study of nurse-initiated behavioural strategies to manage interruptions during medication administration, International journal for quality in health care, doi: 10.1093/intqhc/mzz007.

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Title A cluster randomised controlled feasibility study of nurse-initiated behavioural strategies to manage interruptions during medication administration
Author(s) Johnson, Maree
Langdon, Rachel
Levett-Jones, Tracy
Weidemann, Gabrielle
Manias, ElizabethORCID iD for Manias, Elizabeth orcid.org/0000-0002-3747-0087
Everett, Bronwyn
Journal name International journal for quality in health care
Publisher Oxford Academic
Place of publication Oxford, Eng.
Publication date 2019-03-05
ISSN 1353-4505
1464-3677
Keyword(s) appropriate healthcare, hospital care
behaviour
cluster trial
experimental research
general methodology, risk management
human resources
interruptions
intervention
medications
nursing
patient safety, adverse events
practice variations
professions, training/education
Summary OBJECTIVES: To examine the feasibility of a behavioural e-learning intervention to support nurses to manage interruptions during medication administration. DESIGN: A cluster randomised feasibility trial. SETTING: The cluster trial included four intervention and four control wards randomly selected across four metropolitan hospitals in Sydney, Australia. PARTICIPANTS: We observed 806 (402 pre-intervention and 404 post-intervention) medication events, where nurses prepared and administered medications to patients within the cluster wards. MAIN OUTCOME MEASURES: The primary outcome measured was the observed number of interruptions occurring during administration, with secondary outcomes being the number of clinical errors and procedural failures. Changes in the use of behavioural strategies to manage interruptions, targeted by the e-learning intervention, were also assessed. RESULTS: No significant differences were found in the number of interruptions (P = 0.82), procedural failures (P = 0.19) or clinical errors per 100 medications (P = 0.32), between the intervention and control wards. Differences in the use of specific behavioural strategies (engagement and multitasking) were found in the intervention wards. CONCLUSION: This behavioural e-learning intervention has not been found to significantly reduce interruptions, however, changes in the use of strategies did occur. Careful selection of clinical settings where there is a high number of predictable interruptions is recommended for further research into the impact of the behavioural e-learning intervention. An increase in the intensity of this intervention is recommended with training undertaken away from the clinical setting. Further research on additional consumer-sensitive interventions is urgently needed.
Notes Advance Article
Language eng
DOI 10.1093/intqhc/mzz007
Field of Research 11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30119973

Document type: Journal Article
Collections: Faculty of Health
Centre for Quality and Patient Safety Research
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