Advertisement

The Effects of Clinical Task Interruptions on Subsequent Performance of a Medication Pre-Administration Task

  • Craig WilliamsEmail author
  • Phillip L. Morgan
  • Gary Christopher
  • Nancy Zook
  • Rebbeca Hoskins
Conference paper
Part of the Advances in Intelligent Systems and Computing book series (AISC, volume 972)

Abstract

There is a surge of research exploring the role of task interruptions in the manifestation of primary task errors both in controlled experimental settings, and safety critical workplaces such as healthcare. Despite such research providing valuable insights into the disruptive properties of task interruption, and, the importance of considering the likely disruptive consequences of clinical task interruptions in healthcare environments, there is an urgent need for an approach that best mimics complex working environments such as healthcare, whilst allowing better control over experimental variables with minimal constraints. We propose that this can be achieved with ecologically sensitive experimental tasks designed to have high levels of experimental control so that theoretical as well as practical parameters and factors can be tested. We developed a theoretically and ecologically informed procedural memory-based task - the CAMROSE Medication Pre-Administration Task. Results revealed significantly more sequence errors were made on low, moderate and high complex conditions compared to no interruption condition. There was no significant difference in non-sequence errors. Findings reveal the importance of developing ecologically valid tasks to explore non-observable characteristics of clinical task interruptions. Both theoretical and possible practical implications are discussed.

Keywords

Clinical task interruptions Procedural memory Medication administration 

References

  1. 1.
    Kohn, L., Corrigan, J., Donaldson, M.: To Err is Human. Building a Safer Health System. Committee on Quality of Health Care in America. Institute of Medicine, Washington, DC (1999)Google Scholar
  2. 2.
    Brixey, J.J., Robinson, D.J., Turley, J.P., Zhang, J.: Initiators of interruption in workflow: the role of MDs and RNs. Stud. Health Technol. Inform. 130(103), 103–109 (2007)Google Scholar
  3. 3.
    Werner, N.E., Holden, R.J.: Interruptions in the wild: development of a sociotechnical systems model of interruptions in the emergency department through a systematic review. Appl. Ergon. 51, 244–254 (2015)CrossRefGoogle Scholar
  4. 4.
    Biron, A.D., Loiselle, C.G., Lavoie-Tremblay, M.: Work interruptions and their contribution to medication administration errors: an evidence review. Worldviews Evid.-Based Nurs. 6(2), 70–86 (2009)CrossRefGoogle Scholar
  5. 5.
    Westbrook, J.I., Coiera, E., Dunsmuir, W.T., Brown, B.M., Kelk, N., Paoloni, R., Tran, C.: The impact of interruptions on clinical task completion. BMJ Qual. Saf. 19, 284–289 (2010)CrossRefGoogle Scholar
  6. 6.
    Collins, S., Currie, L., Patel, V., Bakken, S., Cimino, J.J.: Multitasking by clinicians in the context of CPOE and CIS use. In: 2007 Proceedings of the 12th World Congress on Health (Medical) Informatics; Building Sustainable Health Systems, p. 958. IOS Press (2017)Google Scholar
  7. 7.
    Forsyth, K.L., Hawthorne, H.J., El-Sherif, N., Varghese, R.S., Ernste, V.K., Koenig, J., Blocker, R.C.: Interruptions experienced by emergency nurses: implications for subjective and objective measures of workload. J. Emerg. Nurs. 44, 614–623 (2018)CrossRefGoogle Scholar
  8. 8.
    Weigl, M., Müller, A., Vincent, C., Angerer, P., Sevdalis, N.: The association of workflow interruptions and hospital doctors’ workload: a prospective observational study. BMJ Qual. Saf. 21(5), 399–407 (2012)CrossRefGoogle Scholar
  9. 9.
    Westbrook, J.I., Woods, A., Rob, M.I., Dunsmuir, W.T., Day, R.O.: Association of interruptions with an increased risk and severity of medication administration errors. Arch. Intern. Med. 170(8), 683–690 (2010)CrossRefGoogle Scholar
  10. 10.
    Schroers, G.: Characteristics of interruptions during medication administration: an integrative review of direct observational studies. J. Clin. Nurs. 27(19–20), 3462–3471 (2018)CrossRefGoogle Scholar
  11. 11.
    Cloete, L.: Reducing medication errors in nursing practice. Nurs. Stand. 29(20), 50–59 (2015)CrossRefGoogle Scholar
  12. 12.
    Roughead, L., Semple, S., Rosenfeld, E.: Literature review: medication safety in Australia. Australian Commission on Safety and Quality in Health Care (2013)Google Scholar
  13. 13.
    Karavasiliadou, S., Athanasakis, E.: An inside look into the factors contributing to medication errors in the clinical nursing practice. Health Sci. J. 8(1), 32–44 (2014)Google Scholar
  14. 14.
    Johnson, M., Sanchez, P., Langdon, R., Manias, E., Levett-Jones, T., Weidemann, G., Aguilar, V., Everett, B.: The impact of interruptions on medication errors in hospitals: an observational study of nurses. J. Nurs. Manag. 25(7), 498–507 (2017)CrossRefGoogle Scholar
  15. 15.
    Hall, L.M., Pedersen, C., Fairley, L.: Losing the moment: understanding interruptions to nurses’ work. J. Nurs. Adm. 40(4), 169–176 (2010)CrossRefGoogle Scholar
  16. 16.
    Davey, A.L., Britland, A., Naylor, R.J.: Decreasing paediatric prescribing errors in a district general hospital. BMJ Qual. Saf. 17(2), 146–149 (2008)CrossRefGoogle Scholar
  17. 17.
    Elliott, M., Liu, Y.: The nine rights of medication administration: an overview. Br. J. Nurs. 19(5), 300–305 (2010)CrossRefGoogle Scholar
  18. 18.
    Thomas, L., Donohue-Porter, P., Fishbein, J.S.: Impact of interruptions, distractions, and cognitive load on procedure failures and medication administration errors. J. Nurs. Care Qual. 32(4), 309–317 (2017)CrossRefGoogle Scholar
  19. 19.
    Balas, M.C., Scott, L.D., Rogers, A.E.: Frequency and type of errors and near errors reported by critical care nurses. CJNR (Can. J. Nurs. Res.) 38(2), 24–41 (2006)Google Scholar
  20. 20.
    Ozkan, S., Kocaman, G., Ozturk, C., Seren, S.: Frequency of pediatric medication administration errors and contributing factors. J. Nurs. Care Qual. 26(2), 136–143 (2011)CrossRefGoogle Scholar
  21. 21.
    Craker, N.C., Myers, R.A., Eid, J., Parikh, P., McCarthy, M.C., Zink, K., Parikh, P.J.: Nursing interruptions in a trauma intensive care unit: a prospective observational study. J. Nurs. Adm. 47(4), 205–211 (2017)CrossRefGoogle Scholar
  22. 22.
    Sasangohar, F., Donmez, B., Easty, A.C., Trbovich, P.L.: Effects of nested interruptions on task resumption: a laboratory study with intensive care nurses. Hum. Factors 59(4), 628–639 (2017)CrossRefGoogle Scholar
  23. 23.
    Monk, C.A., Trafton, J.G., Boehm-Davis, D.A.: The effect of interruption duration and demand on resuming suspended goals. J. Exp. Psychol.: Appl. 14(4), 299 (2008)Google Scholar
  24. 24.
    Hodgetts, H.M., Jones, D.M.: Interruption of the tower of London task: support for a goal-activation approach. J. Exp. Psychol. Gen. 135(1), 103 (2006)CrossRefGoogle Scholar
  25. 25.
    Campbell, D.J.: Task complexity: a review and analysis. Acad. Manag. Rev. 13(1), 40–52 (1988)CrossRefGoogle Scholar
  26. 26.
    Altmann, E.M., Trafton, J.G.: Memory for goals: an activation-based model. Cogn. Sci. 26(1), 39–83 (2002)CrossRefGoogle Scholar
  27. 27.
    Altmann, E.M., Trafton, J.G.: Timecourse of recovery from task interruption: data and a model. Psychon. Bull. Rev. 14(6), 1079–1084 (2007)CrossRefGoogle Scholar
  28. 28.
    Altmann, E.M., Trafton, J.G., Hambrick, D.Z.: Momentary interruptions can derail the train of thought. J. Exp. Psychol. Gen. 143(1), 215 (2014)CrossRefGoogle Scholar
  29. 29.
    Altmann, E.M., Trafton, J.G., Hambrick, D.Z.: Effects of interruption length on procedural errors. J. Exp. Psychol.: Appl. 23(2), 216 (2017)Google Scholar
  30. 30.
    Trafton, J.G., Altmann, E.M., Ratwani, R.M.: A memory for goals model of sequence errors. Cogn. Syst. Res. 12(2), 134–143 (2011)CrossRefGoogle Scholar
  31. 31.
    Peirce, J., MacAskill, M.: Building Experiments in PsychoPy. Sage, Newcastle upon Tyne (2018)Google Scholar
  32. 32.
    Patterson, C., Maclean, F., Bell, C., Mukherjee, E., Bryan, L., Woodcock, T., Bell, D.: Early warning systems in the UK: variation in content and implementation strategy has implications for a NHS early warning system. Clin. Med. 11(5), 424–427 (2011)CrossRefGoogle Scholar
  33. 33.
    Hodgetts, H.M., Vachon, F., Tremblay, S.: Background sound impairs interruption recovery in dynamic task situations: procedural conflict? Appl. Cogn. Psychol. 28(1), 10–21 (2014)CrossRefGoogle Scholar
  34. 34.
    Collins, S., Currie, L., Bakken, S., Cimino, J.J.: Interruptions during the use of a CPOE system for MICU rounds. In: 2006 AMIA Symposium, p. 895. American Medical Informatics Association (2006)Google Scholar
  35. 35.
    Collins, S., Currie, L., Patel, V., Bakken, S., Cimino, J.J.: Multitasking by clinicians in the context of CPOE and CIS use. In: 2007 Proceedings of the 12th World Congress on Health (Medical) Informatics; Building Sustainable Health Systems, p. 958. IOS Press (2007)Google Scholar
  36. 36.
    Benda, N.C., Meadors, M.L., Hettinger, A.Z., Ratwani, R.M.: Emergency physician task switching increases with the introduction of a commercial electronic health record. Ann. Emerg. Med. 67(6), 741–746 (2016)CrossRefGoogle Scholar
  37. 37.
    Morgan, P.L., Patrick, J., Waldron, S.M., King, S.L., Patrick, T.: Improving memory after interruption: Exploiting soft constraints and manipulating information access cost. J. Exp. Psychol.: Appl. 15(4), 291 (2009)Google Scholar
  38. 38.
    Morgan, P.L., Patrick, J.: Paying the price works: increasing goal-state access cost improves problem solving and mitigates the effect of interruption. Q. J. Exp. Psychol. 66(1), 160–178 (2013)CrossRefGoogle Scholar
  39. 39.
    Morgan, P.L., Patrick, J., Tiley, L.: Improving the effectiveness of an interruption lag by inducing a memory-based strategy. Acta Physiol. (Oxf) 142(1), 87–95 (2013)Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Craig Williams
    • 1
    Email author
  • Phillip L. Morgan
    • 2
  • Gary Christopher
    • 1
  • Nancy Zook
    • 1
  • Rebbeca Hoskins
    • 1
  1. 1.Department of Health and Social SciencesUniversity of the West of England (UWE) – BristolBristolUK
  2. 2.School of Psychology, Human Factors Excellence Research GroupCardiff UniversityCardiffUK

Personalised recommendations