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Training student nurses to deal with interruptions may improve patient safety


Training nursing students how to deal with interruptions when administering medication can help reduce errors and improve patient safety, suggests a new study.

Undergraduate nurses generally learn how to administer medicine in a “calm and uninterrupted” training environment, noted researchers.

“It is imperative that nurses are taught to effectively manage interruptions”

Study authors

But they said this does not reflect the realities of everyday nursing and argued that nurses working on busy wards often have to contend with “multiple interruptions” while giving out medication.

The impact of interruptions can be very serious, highlighted the study authors from Australia and the UK.

If mistakes are made then patients could be harmed or die, families left devastated and the administering nurse may also “suffer professionally, physically and emotionally”, they said.

“Considering that the administration of medications can absorb up to 40% of a nurse’s time and the undeniable links to medication errors, it is imperative that nurses are taught to effectively manage interruptions,” they added.

Students took part in the role play exercise in groups of five, taking on various roles, including playing the part of a nurse trying to give medication, another nurse who interrupts with various requests and a confused patient who also causes interruptions such as asking to go home and to the toilet.

“The student undertaking the registered nurse role was required to administer charted medications to one of the two patients and manage interruptions as they occurred,” they stated in the study paper.

“It was good to practice in a situation that is more like what we’ll experience in real life”

Student nurse

They set out to test whether recreating the more “chaotic” atmosphere of hospital work could prepare students better for clinical practice.

The findings, published in the Journal of Clinical Nursing, are based on feedback from more than 450 second year nursing students who took part in a simulated role-play experience at a large university.

Students were debriefed in their role-play groups and then as a whole class. In all 451 of the total 528 students who took part wrote down their thoughts, handing in their feedback within two weeks of the simulation.

An analysis of these responses revealed heightened awareness of the significant impact of interruptions on a nurse’s work and ability to think clearly and the “unpredictable nature of nursing”.

“Students reported recognising and understanding that to be able to effectively manage in the real clinical environment they need to be exposed to challenges in the laboratory setting,” said the researchers, led by Carolyn Hayes from the University of Technology Sydney.

They suggested that the exercises had helped students to develop skills, including “multi-tasking”, prioritisation and time management, and also learn the importance of concentrating on the task in hand. Many also said the exercise had boosted their confidence.

University of Technology Sydney-

Training students to deal with interruptions improves care

Carolyn Hayes

“[The simulation] prepared me for clinical practice by allowing me to think about what I would do in this situation and ways to better manage common distractions,” said one participant. “So far in class we have concentrated on episodic care in ideal calm and quiet conditions so it was good to practice in a situation that is more like what we’ll experience in real life.”

Most also said they had enjoyed learning in this way, although the study paper noted that the exercise “did prove challenging” for some.

The researchers said the results showed teaching nurses how to administer medication in a realistic but safe setting had many benefits, including encouraging critical thinking and sound clinical judgements.

“Providing realistic teaching experiences to undergraduate nursing students is crucial if we are to prepare them adequately to meet the demands of professional practice,” said the study paper.

“Ensuring students were exposed to common interruptions during medication administration using role-play simulation may improve student understanding of the implications of interruptions and allow them to consider the need for strategies that are transferable to the clinical environment,” it said.


Readers' comments (4)

  • What ward is calm and uninterrupted? As a student this is where we administer the drugs and yes....we are interrupted!!

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  • I feel that as a third year student I have had plenty of interruptions during drugs rounds and am able to deal with these. I cannot remember a drugs round that was in a calm and controlled environment, especially considering it is something you do not practice in the skills lab at university.
    I feel that this article may not fully reflect what actually occurs in practice.

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  • Laura Hodgetts

    I think it is a very useful skill to have but to be honest I would rather have tough books or computers are consistently able to work, don't freeze and allow for constant checking of prescriptions at the patients bedside in order to reduce medicine errors.

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  • I have read that 'multi-tasking' is pretty much impossible with respect to how our brains actually work and we perform tasks more successfully with less errors one at a time rather than simultaneously. Therefore I don't think it is safe, responsible or wise to promote the concept of multi-tasking as a "skill" to aspire to,...especially in the context of reducing medication errors! Other than that criticism I think teaching students to deal with interruptions in university is a fantastic and innovative idea.

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