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Quantifying the relationship between physical environmental variables and interruption events during the medication

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Longer travel distances and smaller unit sizes increase interruptions during medication administration in intensive care units (ICUs). Optimizing ICU design can enhance patient safety.

Keywords:
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Area of Science:

  • Nursing Science
  • Patient Safety Research
  • Healthcare Environmental Design

Background:

  • Interruptions during medication administration in intensive care units (ICUs) pose risks to patient safety.
  • The influence of physical environmental factors on these interruptions is not well understood.

Purpose of the Study:

  • To investigate the relationship between physical environmental features and interruptions during medication administration in ICUs.
  • To quantify the impact of travel distance, unit size, and location on interruption frequency and duration.

Main Methods:

  • Observational study shadowing 18 nurses during 100 medication rounds (29.25 hours) across three ICUs.
  • Data collection included recording interruptions and nurse travel paths.
  • Analysis involved descriptive statistics, path visualization, heatmaps, and multiple linear regression.

Main Results:

  • A total of 1,115 interruptions were recorded, with self-initiated and nurse-to-nurse interactions being most common.
  • Each 100-foot increase in travel distance correlated with a 26.8% rise in interruptions.
  • Medium and large ICUs experienced significantly fewer interruptions than small units; noon rounds had fewer interruptions than afternoon rounds.
  • Interruptions were longer at nurse stations and corridors compared to patient rooms.

Conclusions:

  • Travel distance and ICU unit size are significant determinants of interruption patterns.
  • Evidence-based design strategies focusing on optimizing ICU layout can reduce interruptions.
  • Improving the physical environment of ICUs holds potential for enhancing medication administration safety.