Nursing Work and Responses to Interruptions

Abstract

Interruptions are multi-dimensional events that occur at varying frequencies and durations in different social contexts and task environments. Given that interruptions are believed to be pervasive in the nursing work environment and patient care requires a great amount of cognitive resources, it is important to describe nurses’ responses to interruptions in the direct care work environment. Of major concern is the potential link between interruption and errors. Until types of interruptions and responses are described, it is not possible to study this potential link. The purpose of this study was to examine nurses’ responses to and management of interruptions during patient care and to explore contextual factors that influence nurse decision-making when interrupted. The findings indicate that nurses are interrupted frequently during their work. Nurses acted immediately on 95% of interruptions with either a task switch (47.9%) or by multitasking (46.7%). Characteristics (task type, source, and initiation method), of the first interruption during a task were associated with the nurses’ responses. Likewise, characteristics of the interrupted task were associated with the nurses’ response to the first interruption. A large proportion (26%) of interruptions occurred during medication administration (a time when errors may result in the most harm to patients) when current evidence and protocols call for limiting interruptions. This finding may be clinically meaningful in development of practice interventions related to interruption handling strategies. Other findings regarding data collection strategies to study this phenomenon will guide future research.