Interruption reduction during oral medication rounds among nurses in hematology-oncology wards: a best practice implementation project

Abstract

ABSTRACT Objectives: The aim of the project was to reduce interruptions during oral medication rounds among nurses working in hematology-oncology wards by improving compliance with best practices by 20%. Introduction: Medication errors can adversely affect patient safety. Hence, understanding the underlying contributors to medication errors is necessary. Nurses are the ones who administer medications to patients; however, in clinical areas, interruptions are prevalent and could contribute to medication errors. It is therefore recommended that interventions be implemented to minimize interruptions. Methods: This project was conducted in two hematology-oncology wards from March 2022 to March 2023. Target participants were nurses who served medications in the morning. The project followed an evidence-based audit and feedback methodology using the seven-phase JBI Evidence Implementation Framework. JBI's Practical Application of Clinical Evidence System (PACES) was used to support the audit and feedback process. An interruption reduction bundle consisting of three best practices was implemented. Results: At baseline, only 24% of medications administered occurred without interruption. One month after implementation, there was a 51% improvement in compliance. Six months after implementation, compliance increased to 58%. Nine months post-implementation, the compliance rate remained at 59%. Absolute interruption counts decreased from 47 (baseline), to 27 (1 month post-implementation), to 24 (6 months post-implementation), to 16 (9 months post-implementation). All types of interruptions decreased when comparing the baseline with the latest post-implementation result. Conclusions: The project used evidence-based interventions in a bundle, effectively reducing interruptions during oral medication rounds, and sustaining positive results. Spanish abstract: http://links.lww.com/IJEBH/A256