Recent Research About Nursing, May 2010

New research gauges the impact of interrupting nurses while they are administering medication, tests the value of patient bar code systems and solicits nurses' views on electronic medical records.

    • May 26, 2010

Don’t Interrupt!

A new study published in The Archives of Internal Medicine concludes that the kinds of interruptions nurses routinely face while administering medicine can significantly increase the likelihood of a medical mistake.

“We found that the more interruptions a nurse received while administering a drug to a specific patient, the greater the risk of a serious error occurring,” says Johanna I. Westbrook, Ph.D., lead author of the study and director of the Health Informatics Research and Evaluation Unit at the University of Sydney in Australia.

Westbrook and colleagues observed nurses administering medications in six wards at two major teaching hospitals in Sydney, Australia, and tracked the number of times nurses were interrupted during the process, as well as such “procedural” failures as the use of aseptic technique and such “clinical” errors as incorrect doses. Each interruption was associated with a 12.1 percent increase in the number of procedural failures and a 12.7 percent increase in clinical errors. Strikingly, interruptions occurred in 53.1 percent of medicine administrations. Nurses’ experience provided no protection against clinical errors, researchers found. Most errors in the study were considered minor, but 2.7 percent were considered major clinical errors.

Patient Bar Codes Help Avoid Errors

A recently published study in the New England Journal of Medicine finds that a bar-code system helped reduce the chances of patients getting the wrong medicine by 57 percent.

Eric Poon, M.D., M.P.H., of Brigham and Women’s Hospital in Boston, and colleagues studied error rates in order transcription and medication administration, both before and six weeks after the implementation of an electronic medication administration record (eMAR) bar-code system at Brigham and Women’s. They found that the rate of potential adverse drug events fell from 3.1 percent without the bar-code to 1.6 percent with it. They concluded that “use of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events, although it did not eliminate such errors. Our data show that the bar-code eMAR is an important intervention to improve medication safety.”

RNs Split on EHRs

A new survey of registered nurses finds that they are split on the merits of electronic health records and charting systems in hospitals.

The AFT Healthcare survey of 604 hospital nurses, conducted for the American Federation of Teachers, found that 49 percent of respondents said their electronic health records systems have had a positive effect on the overall quality of patient care, while 47 percent said they have had a negative effect.

In addition, 49 percent of respondents said that the electronic health records systems have had a negative effect on stress levels. Half (50 percent) said they have had a negative effect on the amount of time needed to chart patient information (versus 38 percent who said they have had a positive effect). “There is a right way and a wrong way to bring this kind of important change to the health industry. It needs to be done well, so that it succeeds in achieving better-quality patient care,” said AFT President Randi Weingarten, J.D. “When technology is introduced with little or no consultation with frontline workers, there’s a lot of unnecessary stress and wasted time and money, as many nurses have found. To guard against that, nurses’ opinions and concerns need to be heard.”

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