Abstract
OBJECTIVES: The objective of this project was to contribute to the understanding of how interruptions impact intravenous (IV) medication processes and identify areas for improvement. The specific aims were to evaluate the type, frequency, and duration of interruptions, including IV smart pump (IVSP) alerts and alarms, that nurses experience during IVSP activities. DESIGN: Real-world observational, exploratory, noninterventional design. METHODS: Level 1 academic medical center in the Northeast region of the United States. Data on interruptions were documented using an electronic Case Report Form. RESULTS: One hundred IVSP medication administration activities were observed, of which 25% encountered at least one IVSP alert or alarm. The mean duration for each alert/alarm was 17.9 seconds and alerts/alarms occurred every 1.69 minutes during the medication administration activity. Alarms and alerts accounted for 24.5% of the total duration of each IVSP activity, indicating that nurses spent about 25% of their medication administration time responding to alerts/alarms. Regarding other types of interruptions, 44% of the 100 IVSP medication administration activities experienced at least one interruption, averaging 1.23 per activity. The main sources of interruptions were health care professionals (20.4%), medical devices (20.4%), and other nurses (16.7%). Phone calls created the longest interruptions, averaging 48.0 seconds, followed by self-initiated interruptions at 45.7 seconds. CONCLUSION: Findings reveal that interruptions, including IVSP alerts and alarms, significantly impact IV medication administration, consuming nearly 25% of nurses' activity time. Additional interruptions, often caused by health care professionals and phone calls, further disrupt workflows and extend task durations. Addressing these challenges through streamlined alert systems and improved communication protocols is essential to enhance efficiency and patient safety in clinical settings.