Interruptions experienced by registered nurses working in the emergency department.
A descriptive, observational study was performed to determine (a) the frequency (number of interruptions per hour) that a typical ED nurse experiences interruptions, (b) the type of interruptions a typical ED nurse experiences, and (c) the percentage of interruptions that take place during medication related activities. A convenience sample of 30 nurses from 3 emergency departments of a major metropolitan academic medical center were each observed for 120 minutes to determine how many interruptions per hour the ED nurse experienced, the type of interruptions and what percentage of these interruptions took place during medication-related activities. A data collection tool was developed to record tasks performed by the nurses and the type of interruptions experienced. Interrater reliability was established with a Kappa of 0.825. A total of 200 interruptions occurred during the 60 hours of observation, or 3.3 interruptions per hour per RN. Of the 20 possible types of interruptions that were identified a prior to the observation period, 11 different types of interruptions were actually observed. The majority of interruptions (95%) were related to face-to-face communications with others in the ED. The total number of interruptions related to medication activities was 55 (27.5% of the total number of interruptions). The results of this study can serve as the basis for subsequent, larger studies that examine more closely the relationship between interruptions and errors in the ED, with the ultimate goal of developing interventions to reduce medication errors and other adverse events that occur due to nurse interruptions.