Stop - Attention Thief! Managing Distractions During Medication Administration

Abstract :

Background: Medical error is the third leading cause of death in the U. S. with medication errors the most common. Distractions occurring in healthcare are linked to errors in medication administration (MA). Evidence supports nurses’ belief that medication errors are caused by competing demands distracting them during MA.

Purpose: The purpose of this pilot project was to explore the effectiveness of a simulation bundle including distraction training and a standardized patient (SP) simulation-based experience (SBE) focusing on management of distractions during MA.

Methods: A mixed methods randomized pre-post design of undergraduate nursing students was used to evaluate the strategy of a simulation bundle including distraction training and a standardized patient SBE with distractions during MA.
Data analysis: Outcomes measured pre- post- include student satisfaction and self-confidence with MA and distraction strategies and scores from the Medication Safety Critical Element Checklist.

Results: 59 students participated in distraction training and SBEs. Most missed items included: allergies (28/59), assessments (8/59), labs (12/59) and patient/med scanned (38/59). Distractions included phone calls, patient’s unrelated conversations, and other healthcare providers. Scores of: “My confidence level coping with distractions during MA” went from 3.5 to 3.65; “I am confident I have the skills and knowledge necessary to cope with distractions while administering medication” increased from 3.5 to 3.82.

Conclusion: Use of an innovative strategy exposing nursing students to management of distractions during MA proved highly valuable. Students indicated gaining a deeper understanding and improved confidence in managing distractions during MA, hopefully impacting their performance as future nurses.