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Operational failures and interruptions in hospital nursing
Anita L Tucker1, Steven J Spear
1The Wharton School, University of Pennsylvania, 551 Huntsman Hall, 3730 Walnut Street, Philadelphia, PA 19104-6340, USA.
Health Services Research
|May 18, 2006
Summary
Hospital nurses face frequent work system failures impacting patient care. Addressing issues with medications, supplies, and staffing can improve nurse productivity and reduce errors.
Area of Science:
- Healthcare Management
- Nursing Practice
- Health Systems Engineering
Background:
- Hospital nurses' work environment is critical for patient care delivery.
- Work systems providing information, materials, and equipment significantly influence nurse performance.
Purpose of the Study:
- To describe the hospital nurse work environment.
- To focus on the performance of work systems supporting patient care.
- To examine the frequency and impact of work system failures on nurse productivity.
Main Methods:
- Cross-sectional study in six U.S. hospitals.
- Direct observation of 11 nurses' activities (minute-by-minute).
- Semistructured interviews with nurses and surveys for nurses and managers on work system failures.
Main Results:
- Nurses experienced an average of 8.4 work system failures per 8-hour shift.
- Top failures involved medications, orders, supplies, staffing, and equipment.
- Nurses had an average task time of 3.1 minutes and were interrupted 8 times per shift.
Conclusions:
- Improving work systems by addressing failures can increase nurse effectiveness.
- Designing interruption-robust processes is essential for preventing errors in fragmented nursing work.
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