None listed
Conditions
Brief summary
Aim: To develop and pilot test an intervention to improve nurses’ abilities to manage interruptions during the administration of medications, thereby reducing medication errors and potentially, patient’s length of stay. Primary hypothesis: Interruptions associated with medication administration events will be reduced by 40%% where nurses undertake education and simulation experiences compared to nurses not receiving any education. Secondary hypothesis: There will be a 25% reduction in clinical and procedural errors during medication administration where nurses undertake and education program and / or simulation experience compared to nurses not receiving any education. Design: A CRCT is proposed to test these hypotheses as the simulation experiences, by their nature, need to be applied to groups of nurses or wards. Clinical and procedural error data will be collected at the nurse level, targeting nurses per ward. Sample and Setting: clusters of medical and surgical units and nurses (and patients) from SWSLHD hospitals form the sample. Randomisation: wards will be randomly assigned to the education or control arm. Due to the nature of the intervention, no blinding of ward nurses will be possible. Research staff involved in group allocation and analysis will be blinded to the allocation. Developing the intervention: Preliminary studies have been completed identifying sources of interruptions, extent of the problem, and use of behavioural strategies (positive and negative). Cognitive load and processing and strategies to manage the range of interrupters (nurses, doctors, patients, equipment), combined with strategies gleaned from focus group studies and observations of nurses form a 20 minute educational program including simulations.
Interventions
The project will involve two groups - a control group and an intervention group. The practice of the control group will not differ from normal, standard medication administration practice. The intervention group will undertake an investigator-facilitated 30-60 minute education program including viewing a 20 minute DVD with details of the incidence of interruptions, behavioural strategies of managing interruptions and simulations of interruptions and panel discussion by nursing leaders on changin
The project will involve two groups - a control group and an intervention group. The practice of the control group will not differ from normal, standard medication administration practice. The intervention group will undertake an investigator-facilitated 30-60 minute education program including viewing a 20 minute DVD with details of the incidence of interruptions, behavioural strategies of managing interruptions and simulations of interruptions and panel discussion by nursing leaders on changing ward culture. A register of all nursing staff within wards will be established and attendance will be monitored. Ward posters noting "In the interest of patient safety please do not interrupt nurses administering medications" will be placed within patient areas.
Sponsors
Centre for Applied Nursing Research, Ingham Institute, South Western Sydney Local Health District
Study design
Allocation
Randomised controlled trial
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Nursing Unit Manager of the general medical/surgical clinical areas within major metropolitan hospitals within South Western Sydney Local health District (cluster). Critical care units are excluded from the study. Registered and Enrolled nurses (certified to undertake medication administration) who routinely administer medications to patients. Patients admitted to the intervention and control wards who are receiving one or more medications.
Exclusion criteria
Critical care units
Outcome results
None listed