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DTSTAMP:20240325T185835Z
LOCATION:Salon A-4
DTSTART;TZID=America/Chicago:20240326T133000
DTEND;TZID=America/Chicago:20240326T135200
UID:HFESHCS_2024 International Symposium on Human Factors and Ergonomics i
 n Health Care_sess139_INDLEC104@linklings.com
SUMMARY:Interruption Management: Education and Practice using Simulations 
 with Embedded Interruptions
DESCRIPTION:Oral Presentations\n\nGinger Schroers (Loyola University Chica
 go)\n\nTopics that will be included in this presentation include: \n1) an 
 interruption management strategy (i.e., skills to handle interruptions) th
 at can be taught and practiced using simulated scenarios \n2) the signific
 ance of embedding interruptions into healthcare simulated scenarios\n3) us
 e of theories and evidence to inform the details (e.g., source, reason, lo
 cation, timing, duration) of interruptions embedded in simulated scenarios
 \n\nApplication:\nA research study was conducted to assess the feasibility
  and acceptability of teaching and applying an innovative interruption man
 agement strategy, termed the Stay S.A.F.E. strategy. Stay S.A.F.E. is an a
 cronym for: STAY physically where you are, Stay engaged with the task, Ass
 ociate cues, such as by holding items, and/or placing a finger on the work
 ing area, Find a natural break in the task to pause, and Evaluate the urge
 ncy of the interruption. The intent of using the Stay S.A.F.E. strategy wh
 en interrupted is to mitigate errors and improve task efficiency. \n\nSimu
 lated scenarios with embedded interruptions from team members (played by t
 rained actors), were developed to provide the context for undergraduate nu
 rsing student participants to apply the Stay S.A.F.E. strategy. Guided by 
 cognitive science theories and evidence from healthcare research, the sour
 ce, reason, location, duration, and timing of the interruptions were caref
 ully planned and executed. \n\nStudent participants were taught how to app
 ly each step of the Stay S.A.F.E. strategy through didactic educational me
 thods. The 10 minute didactic education session included a slides presenta
 tion, video demonstration of a nurse applying the strategy during medicati
 on administration, and discussion. Following receipt of the didactic educa
 tion, students engaged in 10-15 minutes of hands-on practice using the str
 ategy during an interrupted medication administration simulated scenario. 
 Each student then experienced an individual interrupted simulated medicati
 on administration scenario to allow for observational quantitative data co
 llection on the strategy. \n\nStudents returned four to six weeks after th
 eir initial learning and practice of the strategy to experience a new inte
 rrupted medication administration scenario. Observational data were collec
 ted, and students discussed their perceptions of the scenarios and Stay S.
 A.F.E. strategy. The qualitative data were collected via semi-structured i
 nterviews.\n\nResults:\nThe Stay S.A.F.E. strategy was found to be feasibl
 e to teach and implement, and acceptable to study participants. Analysis o
 f the observational data found that the strategy averaged four seconds to 
 apply. During the interviews, participants described the simulated scenari
 os and interruptions as realistic, interruption management strategy as eas
 y to use and remember, and voiced increased confidence in handling interru
 ptions 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 int
 errupted while playing a video game). \n\nBackground: \nWorldwide, interru
 ptions are pervasive in healthcare settings. Interruptions can result in d
 isorganized thought processes, leading to delayed, missed (i.e., omitted),
  and unsafe patient care. Interruptions are associated with increased freq
 uency and severity of medication administration errors and are prevalent d
 uring nurse medication administration. Observational studies demonstrate t
 hat 94.5-99% of nurse medication rounds are interrupted. Interruptions lea
 d to longer task completion times and decrease task efficiency. Many healt
 hcare organizations have made efforts to decrease interruptions during med
 ication administration, such as through the provision of quiet areas (i.e.
 , no-interruption zones) to prepare medication and “do not interrupt” sign
 age. However, these interventions have not been shown to consistently decr
 ease interruptions or errors, and do not account for necessary interruptio
 ns. Some interruptions may be required, such as a patient emergency or nee
 d to relay time-sensitive information. Thus, researchers recommend that he
 althcare students and practitioners learn to manage, or handle, interrupti
 ons in ways that can mitigate their negative effects. Simulation provides 
 an ideal context to teach and allow learners to practice interruption mana
 gement skills. \n\nPresentation Overview: \nIn this presentation, the spea
 ker will discuss the negative impact of interruptions on patient safety an
 d 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 effic
 iency. The strategy will be described and demonstrated to the audience. De
 tails to be considered when designing simulated scenarios with embedded in
 terruptions will be provided.\n\nKey Take Aways: 1) Interruption managemen
 t skills are critical for healthcare students and practitioners, 2) the St
 ay S.A.F.E. interruption management strategy is feasible to teach and use,
  and 3) simulation with embedded interruptions can afford practice opportu
 nities for learners to apply interruption management strategies.\n\nTrack:
  Simulation and Education\n\nSession Chairs: Michael Boyce (Yale New Haven
  Health) and Carmen Van Ommen (Embry-Riddle Aeronautical University)
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