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Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study

Johanne Alteren, Marit Hermstad, Lisbeth Nerdal, Sue Jordan Orcid Logo

BMC Health Services Research, Volume: 21, Issue: 1, Start page: 1094

Swansea University Author: Sue Jordan Orcid Logo

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DOI (Published version): 10.1186/s12913-021-07122-8

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Abstract: Background: Administering medicines is one of the most high-risk tasks in health care. However, nurses are frequently interrupted during medicine administration, which jeopardises patient safety. Few studies have examined nurses’ experiences and the strategies they adopt to cope with inter...

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Published in: BMC Health Services Research
ISSN: 1472-6963
Published: Springer Science and Business Media LLC 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa58389
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first_indexed 2021-10-18T14:29:11Z
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2021-11-03T12:35:51.9133581</datestamp><bib-version>v2</bib-version><id>58389</id><entry>2021-10-18</entry><title>Working in a minefield; Nurses&#x2019; strategies for handling medicine administration interruptions in&#xA0;hospitals, -a qualtiative interview study</title><swanseaauthors><author><sid>24ce9db29b4bde1af4e83b388aae0ea1</sid><ORCID>0000-0002-5691-2987</ORCID><firstname>Sue</firstname><surname>Jordan</surname><name>Sue Jordan</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-10-18</date><deptcode>HNU</deptcode><abstract>Abstract: Background: Administering medicines is one of the most high-risk tasks in health care. However, nurses are frequently interrupted during medicine administration, which jeopardises patient safety. Few studies have examined nurses&#x2019; experiences and the strategies they adopt to cope with interruptions during medicine rounds. This paper identifies nurses&#x2019; strategies for handling and reducing interruptions and ensuring safety during medicine rounds, within the confines of the hospitals&#x2019; organisational systems. Methods: This descriptive and exploratory research study was undertaken with experienced nurses in Norwegian hospitals in 2015 using semi-structured interviews. Interviews were designed to elicit experiences and strategies used for handling interruptions to medicine rounds. Data were analysed using qualitative content analysis based on inductive reasoning to identify meaningful subjects and reach an interpretive level of understanding regarding nurses&#x2019; experiences. Results: All 19 senior nurses who were approached were interviewed. From 644 condensed meaning units, we identified eight interpretative units and three themes: &#x2018;working in environments of interruptions&#x2019;, &#x2018;personal coping strategies&#x2019;, and &#x2018;management-related strategies&#x2019;. Nurses&#x2019; working environments were characterised by interruptions and distractions, which often threatened patient safety. To handle this unpredictability and maintain ward organisation, nurses developed their own personal strategies to overcome inherent problems with their working conditions, the absence of effective management, and colleagues&#x2019; reluctance to assume responsibility for minimising interruptions. Conclusions: Administration of medicines in hospitals can be described as &#x2018;working in a minefield&#x2019;. Our findings indicate that the hospital management, in cooperation with nurses and other healthcare professionals, should take responsibility for improving the routine process of medicine administration by minimising avoidable interruptions. Patient safety can be improved when the hospital management takes steps to protect nurses&#x2019; work environments and assumes responsibility for resolving these challenges.</abstract><type>Journal Article</type><journal>BMC Health Services Research</journal><volume>21</volume><journalNumber>1</journalNumber><paginationStart>1094</paginationStart><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1472-6963</issnElectronic><keywords>Research, Hospitals, Medicine management, Registered nurses, Patient safety, Management, Work organisation, Work interruptions, Medication errors</keywords><publishedDay>14</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-10-14</publishedDate><doi>10.1186/s12913-021-07122-8</doi><url/><notes/><college>COLLEGE NANME</college><department>Nursing</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HNU</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>Helgeland Hospital Trust, Nord University, and Molde University College</funders><lastEdited>2021-11-03T12:35:51.9133581</lastEdited><Created>2021-10-18T15:26:01.8308133</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Nursing</level></path><authors><author><firstname>Johanne</firstname><surname>Alteren</surname><order>1</order></author><author><firstname>Marit</firstname><surname>Hermstad</surname><order>2</order></author><author><firstname>Lisbeth</firstname><surname>Nerdal</surname><order>3</order></author><author><firstname>Sue</firstname><surname>Jordan</surname><orcid>0000-0002-5691-2987</orcid><order>4</order></author></authors><documents><document><filename>58389__21212__5d65bce2bf584a27831e8d3120b3e2a8.pdf</filename><originalFilename>s12913-021-07122-8.pdf</originalFilename><uploaded>2021-10-18T15:28:10.4776912</uploaded><type>Output</type><contentLength>561958</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2021-11-03T12:35:51.9133581 v2 58389 2021-10-18 Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study 24ce9db29b4bde1af4e83b388aae0ea1 0000-0002-5691-2987 Sue Jordan Sue Jordan true false 2021-10-18 HNU Abstract: Background: Administering medicines is one of the most high-risk tasks in health care. However, nurses are frequently interrupted during medicine administration, which jeopardises patient safety. Few studies have examined nurses’ experiences and the strategies they adopt to cope with interruptions during medicine rounds. This paper identifies nurses’ strategies for handling and reducing interruptions and ensuring safety during medicine rounds, within the confines of the hospitals’ organisational systems. Methods: This descriptive and exploratory research study was undertaken with experienced nurses in Norwegian hospitals in 2015 using semi-structured interviews. Interviews were designed to elicit experiences and strategies used for handling interruptions to medicine rounds. Data were analysed using qualitative content analysis based on inductive reasoning to identify meaningful subjects and reach an interpretive level of understanding regarding nurses’ experiences. Results: All 19 senior nurses who were approached were interviewed. From 644 condensed meaning units, we identified eight interpretative units and three themes: ‘working in environments of interruptions’, ‘personal coping strategies’, and ‘management-related strategies’. Nurses’ working environments were characterised by interruptions and distractions, which often threatened patient safety. To handle this unpredictability and maintain ward organisation, nurses developed their own personal strategies to overcome inherent problems with their working conditions, the absence of effective management, and colleagues’ reluctance to assume responsibility for minimising interruptions. Conclusions: Administration of medicines in hospitals can be described as ‘working in a minefield’. Our findings indicate that the hospital management, in cooperation with nurses and other healthcare professionals, should take responsibility for improving the routine process of medicine administration by minimising avoidable interruptions. Patient safety can be improved when the hospital management takes steps to protect nurses’ work environments and assumes responsibility for resolving these challenges. Journal Article BMC Health Services Research 21 1 1094 Springer Science and Business Media LLC 1472-6963 Research, Hospitals, Medicine management, Registered nurses, Patient safety, Management, Work organisation, Work interruptions, Medication errors 14 10 2021 2021-10-14 10.1186/s12913-021-07122-8 COLLEGE NANME Nursing COLLEGE CODE HNU Swansea University Helgeland Hospital Trust, Nord University, and Molde University College 2021-11-03T12:35:51.9133581 2021-10-18T15:26:01.8308133 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Johanne Alteren 1 Marit Hermstad 2 Lisbeth Nerdal 3 Sue Jordan 0000-0002-5691-2987 4 58389__21212__5d65bce2bf584a27831e8d3120b3e2a8.pdf s12913-021-07122-8.pdf 2021-10-18T15:28:10.4776912 Output 561958 application/pdf Version of Record true The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/
title Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study
spellingShingle Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study
Sue Jordan
title_short Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study
title_full Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study
title_fullStr Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study
title_full_unstemmed Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study
title_sort Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study
author_id_str_mv 24ce9db29b4bde1af4e83b388aae0ea1
author_id_fullname_str_mv 24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
author Sue Jordan
author2 Johanne Alteren
Marit Hermstad
Lisbeth Nerdal
Sue Jordan
format Journal article
container_title BMC Health Services Research
container_volume 21
container_issue 1
container_start_page 1094
publishDate 2021
institution Swansea University
issn 1472-6963
doi_str_mv 10.1186/s12913-021-07122-8
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
document_store_str 1
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description Abstract: Background: Administering medicines is one of the most high-risk tasks in health care. However, nurses are frequently interrupted during medicine administration, which jeopardises patient safety. Few studies have examined nurses’ experiences and the strategies they adopt to cope with interruptions during medicine rounds. This paper identifies nurses’ strategies for handling and reducing interruptions and ensuring safety during medicine rounds, within the confines of the hospitals’ organisational systems. Methods: This descriptive and exploratory research study was undertaken with experienced nurses in Norwegian hospitals in 2015 using semi-structured interviews. Interviews were designed to elicit experiences and strategies used for handling interruptions to medicine rounds. Data were analysed using qualitative content analysis based on inductive reasoning to identify meaningful subjects and reach an interpretive level of understanding regarding nurses’ experiences. Results: All 19 senior nurses who were approached were interviewed. From 644 condensed meaning units, we identified eight interpretative units and three themes: ‘working in environments of interruptions’, ‘personal coping strategies’, and ‘management-related strategies’. Nurses’ working environments were characterised by interruptions and distractions, which often threatened patient safety. To handle this unpredictability and maintain ward organisation, nurses developed their own personal strategies to overcome inherent problems with their working conditions, the absence of effective management, and colleagues’ reluctance to assume responsibility for minimising interruptions. Conclusions: Administration of medicines in hospitals can be described as ‘working in a minefield’. Our findings indicate that the hospital management, in cooperation with nurses and other healthcare professionals, should take responsibility for improving the routine process of medicine administration by minimising avoidable interruptions. Patient safety can be improved when the hospital management takes steps to protect nurses’ work environments and assumes responsibility for resolving these challenges.
published_date 2021-10-14T04:14:53Z
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