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A combined intervention to reduce interruptions during medication preparation and double-checking: a pilot-study evaluating the impact of staff training and safety vests

Authors

  • Saskia Huckels-Baumgart MSc, PhD,

    Project Manager Patient Safety, Corresponding author
    1. Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
    2. Quality Management and Patient Safety, University Hospital Zürich, Zürich, Switzerland
    • Correspondence

      Dr. Saskia Huckels-Baumgart

      University Hospital Zürich

      Quality Management & Patient Safety

      Rämistrasse 100 / Bolleystrasse 40

      8091 Zürich

      Switzerland

      E-mail: saskia.huckels-baumgart@usz.ch

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  • Milena Niederberger MSc,

    Pharmacist
    1. Clinical Pharmacy & Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
    2. Center for Hospital Pharmacy, Cantonal Hospital of Lucerne, Lucerne, Switzerland
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  • Tanja Manser PhD,

    Director Institute for Patient Safety & Vice Dean for Medical Education
    1. Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
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  • Christoph R. Meier PhD,

    Head of Basel Pharmacoepidemiology Unit & Hospital Pharmacy
    1. Clinical Pharmacy & Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
    2. Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
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  • Carla Meyer-Massetti PhD

    Hospital Pharmacist FPH, Postdoctoral Researcher
    1. Clinical Pharmacy & Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
    2. Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
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Abstract

Aim

The aim was to evaluate the impact of staff training and wearing safety vests as a combined intervention on interruptions during medication preparation and double-checking.

Background

Interruptions and errors during the medication process are common and an important issue for patient safety in the hospital setting.

Methods

We performed a pre- and post-intervention pilot-study using direct structured observation of 26 nurses preparing and double-checking 431 medication doses (225 pre-intervention and 206 post-intervention) for 36 patients (21 pre-intervention and 15 post-intervention).

Results

With staff training and the introduction of safety vests, the interruption rate during medication preparation was reduced from 36.8 to 28.3 interruptions per hour and during double-checking from 27.5 to 15 interruptions per hour.

Conclusion

This pilot-study showed that the frequency of interruptions decreased during the critical tasks of medication preparation and double-checking after the introduction of staff training and wearing safety vests as part of a quality improvement process.

Implications for nursing management

Nursing management should acknowledge interruptions as an important factor potentially influencing medication safety. Unnecessary interruptions can be successfully reduced by considering human and system factors and increasing both staff and nursing managers’ awareness of ‘interruptive communication practices’ and implementing physical barriers. This is the first pilot-study specifically evaluating the impact of staff training and wearing safety vests on the reduction of interruptions during medication preparation and double-checking.

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