Presentation
Interruption Management: Education and Practice using Simulations with Embedded Interruptions
DescriptionTopics that will be included in this presentation include:
1) an interruption management strategy (i.e., skills to handle interruptions) that can be taught and practiced using simulated scenarios
2) the significance of embedding interruptions into healthcare simulated scenarios
3) use of theories and evidence to inform the details (e.g., source, reason, location, timing, duration) of interruptions embedded in simulated scenarios
Application:
A research study was conducted to assess the feasibility and acceptability of teaching and applying an innovative interruption management strategy, termed the Stay S.A.F.E. strategy. Stay S.A.F.E. is an acronym for: STAY physically where you are, Stay engaged with the task, Associate cues, such as by holding items, and/or placing a finger on the working area, Find a natural break in the task to pause, and Evaluate the urgency of the interruption. The intent of using the Stay S.A.F.E. strategy when interrupted is to mitigate errors and improve task efficiency.
Simulated scenarios with embedded interruptions from team members (played by trained actors), were developed to provide the context for undergraduate nursing student participants to apply the Stay S.A.F.E. strategy. Guided by cognitive science theories and evidence from healthcare research, the source, reason, location, duration, and timing of the interruptions were carefully planned and executed.
Student participants were taught how to apply each step of the Stay S.A.F.E. strategy through didactic educational methods. The 10 minute didactic education session included a slides presentation, video demonstration of a nurse applying the strategy during medication administration, and discussion. Following receipt of the didactic education, students engaged in 10-15 minutes of hands-on practice using the strategy during an interrupted medication administration simulated scenario. Each student then experienced an individual interrupted simulated medication administration scenario to allow for observational quantitative data collection on the strategy.
Students returned four to six weeks after their initial learning and practice of the strategy to experience a new interrupted medication administration scenario. Observational data were collected, and students discussed their perceptions of the scenarios and Stay S.A.F.E. strategy. The qualitative data were collected via semi-structured interviews.
Results:
The Stay S.A.F.E. strategy was found to be feasible to teach and implement, and acceptable to study participants. Analysis of the observational data found that the strategy averaged four seconds to apply. During the interviews, participants described the simulated scenarios and interruptions as realistic, interruption management strategy as easy to use and remember, and voiced increased confidence in handling interruptions after learning the strategy. Participants voiced using the strategy outside of the study, such as when administering medication during their clinical rotations, while studying, and in casual contexts (e.g., when interrupted while playing a video game).
Background:
Worldwide, interruptions are pervasive in healthcare settings. Interruptions can result in disorganized thought processes, leading to delayed, missed (i.e., omitted), and unsafe patient care. Interruptions are associated with increased frequency and severity of medication administration errors and are prevalent during nurse medication administration. Observational studies demonstrate that 94.5-99% of nurse medication rounds are interrupted. Interruptions lead to longer task completion times and decrease task efficiency. Many healthcare organizations have made efforts to decrease interruptions during medication administration, such as through the provision of quiet areas (i.e., no-interruption zones) to prepare medication and “do not interrupt” signage. However, these interventions have not been shown to consistently decrease interruptions or errors, and do not account for necessary interruptions. Some interruptions may be required, such as a patient emergency or need to relay time-sensitive information. Thus, researchers recommend that healthcare students and practitioners learn to manage, or handle, interruptions in ways that can mitigate their negative effects. Simulation provides an ideal context to teach and allow learners to practice interruption management skills.
Presentation Overview:
In this presentation, the speaker will discuss the negative impact of interruptions on patient safety and quality of care. The Stay S.A.F.E. interruption management strategy will be offered as a potential means to mitigate errors and improve task efficiency. The strategy will be described and demonstrated to the audience. Details to be considered when designing simulated scenarios with embedded interruptions will be provided.
Key Take Aways: 1) Interruption management skills are critical for healthcare students and practitioners, 2) the Stay S.A.F.E. interruption management strategy is feasible to teach and use, and 3) simulation with embedded interruptions can afford practice opportunities for learners to apply interruption management strategies.
1) an interruption management strategy (i.e., skills to handle interruptions) that can be taught and practiced using simulated scenarios
2) the significance of embedding interruptions into healthcare simulated scenarios
3) use of theories and evidence to inform the details (e.g., source, reason, location, timing, duration) of interruptions embedded in simulated scenarios
Application:
A research study was conducted to assess the feasibility and acceptability of teaching and applying an innovative interruption management strategy, termed the Stay S.A.F.E. strategy. Stay S.A.F.E. is an acronym for: STAY physically where you are, Stay engaged with the task, Associate cues, such as by holding items, and/or placing a finger on the working area, Find a natural break in the task to pause, and Evaluate the urgency of the interruption. The intent of using the Stay S.A.F.E. strategy when interrupted is to mitigate errors and improve task efficiency.
Simulated scenarios with embedded interruptions from team members (played by trained actors), were developed to provide the context for undergraduate nursing student participants to apply the Stay S.A.F.E. strategy. Guided by cognitive science theories and evidence from healthcare research, the source, reason, location, duration, and timing of the interruptions were carefully planned and executed.
Student participants were taught how to apply each step of the Stay S.A.F.E. strategy through didactic educational methods. The 10 minute didactic education session included a slides presentation, video demonstration of a nurse applying the strategy during medication administration, and discussion. Following receipt of the didactic education, students engaged in 10-15 minutes of hands-on practice using the strategy during an interrupted medication administration simulated scenario. Each student then experienced an individual interrupted simulated medication administration scenario to allow for observational quantitative data collection on the strategy.
Students returned four to six weeks after their initial learning and practice of the strategy to experience a new interrupted medication administration scenario. Observational data were collected, and students discussed their perceptions of the scenarios and Stay S.A.F.E. strategy. The qualitative data were collected via semi-structured interviews.
Results:
The Stay S.A.F.E. strategy was found to be feasible to teach and implement, and acceptable to study participants. Analysis of the observational data found that the strategy averaged four seconds to apply. During the interviews, participants described the simulated scenarios and interruptions as realistic, interruption management strategy as easy to use and remember, and voiced increased confidence in handling interruptions after learning the strategy. Participants voiced using the strategy outside of the study, such as when administering medication during their clinical rotations, while studying, and in casual contexts (e.g., when interrupted while playing a video game).
Background:
Worldwide, interruptions are pervasive in healthcare settings. Interruptions can result in disorganized thought processes, leading to delayed, missed (i.e., omitted), and unsafe patient care. Interruptions are associated with increased frequency and severity of medication administration errors and are prevalent during nurse medication administration. Observational studies demonstrate that 94.5-99% of nurse medication rounds are interrupted. Interruptions lead to longer task completion times and decrease task efficiency. Many healthcare organizations have made efforts to decrease interruptions during medication administration, such as through the provision of quiet areas (i.e., no-interruption zones) to prepare medication and “do not interrupt” signage. However, these interventions have not been shown to consistently decrease interruptions or errors, and do not account for necessary interruptions. Some interruptions may be required, such as a patient emergency or need to relay time-sensitive information. Thus, researchers recommend that healthcare students and practitioners learn to manage, or handle, interruptions in ways that can mitigate their negative effects. Simulation provides an ideal context to teach and allow learners to practice interruption management skills.
Presentation Overview:
In this presentation, the speaker will discuss the negative impact of interruptions on patient safety and quality of care. The Stay S.A.F.E. interruption management strategy will be offered as a potential means to mitigate errors and improve task efficiency. The strategy will be described and demonstrated to the audience. Details to be considered when designing simulated scenarios with embedded interruptions will be provided.
Key Take Aways: 1) Interruption management skills are critical for healthcare students and practitioners, 2) the Stay S.A.F.E. interruption management strategy is feasible to teach and use, and 3) simulation with embedded interruptions can afford practice opportunities for learners to apply interruption management strategies.
Event Type
Oral Presentations
TimeTuesday, March 261:30pm - 1:52pm CDT
LocationSalon A-4
Simulation and Education