Study finds nursing errors can be attributed to workplace distractions

A major nationwide study co-authored by a Grand Valley nursing professor provides the first detailed description of the nature and prevalence of errors by hospital staff nurses. Last summer, the research team released a study that found the long hours worked by hospital staff nurses may have adverse effects on patient safety. In this follow-up study, the research team analyzed the type of errors and near errors reported by the nurses.

Dr. Linda Scott, Grand Valley associate professor of nursing in the Kirkhof College of Nursing, said reports show that a nurse may be interrupted, on average, at least 19 times during a three-hour period by at least 13 different types of sources. These interruptions may inadvertently result in errors because of the level of activity and complexity of care. In one example, a nurse reported a 90-minute delay in giving medications to one patient and a 40-minute delay to another because she could not leave the bedside of a third unstable patient.

"We need to find ways to reduce distractions by looking at work hours and the work environment in general," said Scott. "Staffing issues, technology and patient assignments are areas that need further examination."

According to participants in the study, frequent interruptions from staff, students, or even the telephone made administering medications and carrying out other patient-care activities challenging. During a 28-day period, 393 registered nurses kept of journal of their errors and near-errors.

Researchers found procedural errors, such as omitting a routine task or making charting and transcription errors often arise from garbled communication within the immediate work area. While it might be impossible to avoid all distractions, the use of technology and paperless charting systems have shown to reduce errors. But such technologies are not widely used and are not user friendly.

Scott said as hospitalized patients become more ill with complex care requirements, and as the nursing shortage intensifies, such situations may become more common.

Scott said it is important to note that the study itself demonstrates that nurses will report errors when they feel safe and when the reporting system is not burdensome. She said it is important to acknowledge the vigilance that led to the nurses catching many of their own errors before they reached the patient.

The study was led by University of Pennsylvania nursing professor Dr. Ann Rogers with the help of Michele C. Balas, a Penn Nursing doctoral student.