Average Number Of Interruptions Research Articles

Improving care safety by characterizing task interruptions during interactions between healthcare professionals: an observational study.

Few studies have investigated interruptions to the work of professionals practicing in inpatient hospitals, and even fewer take account of the functions that make up the system. Safety of care can be improved by considering avoidable interruptions during interactions between managerial and care delivery functions. The present study describes the characteristics of interruptions to the work of professionals working in the inpatient hospital sector, with respect to their typology, frequency, duration, and avoidability in the context of interactions between functions. This direct observational study of interruptions in hospital care was performed in the Pays de la Loire (west coast) area of France. A total of 23 teams (17 institutions) working in medical or surgical specialties (excluding intensive care) were included. Observations were performed between May and September 2019, and lasted seven consecutive hours per team. A pair of observers simultaneously observed the same professional for approximately 30 minutes. Each occupational category was examined. Reported characteristics were: (i) the method and duration of the request, (ii) the location of interrupted and interrupting persons, (iii) the reaction of the interrupted person, (iv) the characteristics of the interrupting person; and (v) the classification of interrupted and interrupting tasks according to their function. An avoidable interruption was defined. Interruptions during interactions between professionals were categorised in terms of their function and avoidability. Descriptive statistical analyses (mean, standard deviation, distribution) were run. In particular, cross-comparisons were run to highlight avoidability interruptions and interactions between managerial and care delivery functions during the working day, for different professional categories, and for the location of the request. Overall, 286 interrupted professionals were observed and 1,929 interruptions were characterised. The majority of interruptions were due to a face-to-face request (58.7%), lasting ≤30 seconds (72.5%). Professionals engaged in the response in 49.3% of cases. A total of 57.4% of interruptions were avoidable. The average number of interruptions was 10.5 (SD=3.2) per hour per professional. An analysis of avoidability and interactions between managerial and care delivery functions found that the period between 12:00 and 13:00 was the riskiest in terms of care safety. This study highlighted the characteristics of interruptions to the activity of professionals working in inpatient hospitals. Care teams could focus on making medical and nursing professionals much more aware of the importance of interruptions, and each team could decide how to best-manage interruptions, in the context of their specific working environment.

Improving Efficiency and Quality of Handover in the Mental Health Liaison Team (MHLT): A Focus on Achieving Team Buy-In

AimsTo Reduced Mental Health Liaison Team (MHLT) handover time to less than 30 minutes within one month and to improve the quality of handover. The non-medical staff have been part of the team for many years, whilst medical staff have recently changed or are on short rotations. Previous changes have not been well sustained. Much of the initial enthusiasm for this project was coming from the medical staff members. We felt that it was important to fully explore the driving human factors to achieve sustainable buy-in.MethodsThe total period of the project was 7 weeks. First two weeks were used for daily baseline data-collection and informal and formal discussions with team members to formulate driver diagram and change ideas. Two “Plan, Do, Study, Act” (PDSA) cycles with two intervention points at week 3 and week 4.ResultsKey human factors identified in the MHLT were burnout and emotional fatigue, core team values (cohesion, flexibility, and camaraderie), and disillusion with authority and imposed change. Contributing factors to burnout and emotional fatigue were long and short-term staff sickness, chronic under-staffing, and systemic changes in the general hospital due to the COVID-19 pandemic. The human factors were used to guide key decisions in methodology and creation of change ideas. These decisions included: Avoidance of surveys and questionnaires (staff request), limiting the total number of changes, any additional administration to be undertaken by medical staff, and avoiding a rigid handover system. Following 2 PDSA cycles, there were improvements in average length of handover from 44 minutes (2-week baseline data) to 30 minutes (4-weeks post second intervention). When compared to the baseline data there were also improvements in the average number of interruptions (7 vs 2), availability of key information (69% vs 92%), allocation of staff member (80% vs 95%) and allocation of review date (83% vs 95%). No difference in the average number of patients for handover discussion between 2-week baseline data (15) and the 5 weeks after (15).ConclusionThe aims for the Quality Improvement Project were met and a plan has been set to re-audit in both 6 months and 1 years’ time to test sustainability of change. Sudden illness and effects of the COVID-19 pandemic have led to short and long-term staff shortage, contributing to burnout and emotional fatigue. Attention to the unique human factors involved in team dynamics and staff morale can help achieve buy-in and real change.

AORN Position Statement on Managing Distractions and Noise During Perioperative Patient Care

<scp>AORN</scp> Position Statement on Managing Distractions and Noise During Perioperative Patient Care

Reducing interruptions during duty radiology shifts, assessment of its benefits and review of factors affecting the radiology working environment

To investigate and reduce the number of inappropriate interruptions to the duty radiology registrar, as well as subjectively assess the effect of reducing interruptions and identify other methods of improving the duty working environment. A pre- and post-intervention prospective quantitative study and post-intervention retrospective qualitative study of duty radiology registrars was performed at a tertiary referral centre. The first cycle of the quantitative study was performed prior to implementation of a telephone triage system. The second cycle and qualitative study were performed afterwards. The average number of interruptions per day dropped by 43.7% after the intervention. Moreover, inappropriate interruptions dropped from one in three to one in five interruptions. Improvement was demonstrated following the intervention for perceived patient safety, workload, reporting efficiency, reporting accuracy, work satisfaction, and stress. The most common hindrance to a good working environment was interruptions (36%). The most common suggestion for improvement was improved comfort (33%). The present study demonstrates that a telephone triage system can substantially reduce the number of interruptions to the duty radiologist. It also demonstrates that reducing interruptions in radiology has the potential to improve the working environment in many ways.

Supply and demand: application of Lean Six Sigma methods to improve drug round efficiency and release nursing time.

To improve efficiency, reduce interruptions and reduce the time taken to complete oral drug rounds. Lean Six Sigma methods were applied to improve drug round efficiency using a pre- and post-intervention design. A 20-bed orthopaedic ward in a large teaching hospital in Ireland. Pharmacy, nursing and quality improvement staff. A multifaceted intervention was designed which included changes in processes related to drug trolley organization and drug supply planning. A communications campaign aimed at reducing interruptions during nurse-led during rounds was also developed and implemented. Average number of interruptions, average drug round time and variation in time taken to complete drug round. At baseline, the oral drug round took an average of 125 min. Following application of Lean Six Sigma methods, the average drug round time decreased by 51 min. The average number of interruptions per drug round reduced from an average of 12 at baseline to 11 following intervention, with a 75% reduction in drug supply interruptions. Lean Six Sigma methodology was successfully employed to reduce interruptions and to reduce time taken to complete the oral drug round.

Analysis of secondary user performance in cognitive radio networks with reactive spectrum handoff

Cognitive radio networks use dynamic spectrum access of secondary users (SUs) to deal with the problem of radio spectrum scarcity . In this paper, we investigate the SU performance in cognitive radio networks with reactive-decision spectrum handoff. During transmission, a SU may get interrupted several times due to the arrival of primary (licensed) users. After each interruption in the reactive spectrum handoff, the SU performs spectrum sensing to determine an idle channel for retransmission. We develop two continuous-time Markov chain models with and without an absorbing state to study the impact of system parameters such as sensing time and sensing room size on several SU performance measures. These measures include the mean delay of a SU, the variance of the SU delay, the SU interruption probability, the average number of interruptions that a SU experiences, the probability of a SU getting discarded from the system after an interruption and the SU blocking probability upon arrival.

Medication Administration Interruptions in a Rural Hospital and Evaluation of a Red Light Intervention

Purpose: This study was conducted to determine the prevalence and types of interruptions nurses experience during the peak medication administration period (weekdays 7:00 AM-9:00 AM) at a rural regional hospital and to evaluate the effectiveness of a red light intervention to reduce interruptions. Sample: Participants were a convenience sample of registered nurses who agreed to be observed administering medications. The same nurses were observed during both phases of the study. Methods: This study employed a prospective exploratory design. The same observation procedures were used during both phases of the study. During each 2-hour observation period, each participating nurse was accompanied by two observers who recorded all interruptions. During the intervention, a small flashing red light was attached to the medication administration computer. When turned on it served as a signal to avoid interruptions. Educational flyers were distributed to staff, physicians, patients, and visitors to inform them about the meaning of the light. Findings: Average interruptions per 2-hour medication administration period dropped from an average of 7.2 during baseline to 3.0 during the red light intervention. The top two source of interruptions during both phases were other personnel and not having needed medical supplies/equipment, though the rankings were reversed. The relative prevalence of interruptions caused by other personnel declined from 27.6% (baseline) to 21.8% (intervention). Conclusions: The major categories of interruptions at this rural regional acute care hospital were similar to those identified in studies in urban settings. The red light intervention effectively reduced the average number of interruptions per 2-hour period and reduced the incidence of interruptions caused by other personnel. The prevalence of interruptions due to missing supplies/equipment remained high and should be addressed by implementing procedures to ensure that carts are appropriately stocked. DOI: http://dx.doi.org/10.14574/ojrnhc.v15i2.327 Keywords: Medication administration, Interruptions, Rural

Localization of single-chain interruptions in bacteriophage T5 DNA I. Electron microscopic studies

Bacteriophage T5 DNA was examined in an electron microscope after limited digestion with exonuclease III from Escherichia coli. The effect of the exonuclease treatment was to convert each naturally occurring single-chain interruption in T5 DNA into a short segment of single-stranded DNA. The locations of these segments were determined for T5st(+) DNA, T5st(0) DNA, and fragments of T5st(0) DNA generated by EcoRI restriction endonuclease. The results indicate that single-chain interruptions occurr in a variable, but nonrandom, manner in T5 DNA. T5st(+) DNA has four principal interruptions located at sites approximately 7.9, 18.5, 32.6, and 64.8% from one end of the molecule. Interruptions occur at these sites in 80 to 90% of the population. A large number of additional sites, located primarily at the ends of the DNA, contain interruptions at lower frequencies. The average number of interruptions per genome, as determined by this method, is 8. A similar distribution of breaks occurs in T5st(0) DNA, except that the 32.6% site is missing. At least one of the principal interruptions is reproducibly located within an interval of 0.2% of the entire DNA.

Prediction of Grade Point Average from Estimated Study Behaviors

In an assessment of the relations between test anxiety, study behavior, and academic performance Allen, Lerner, and Hinrichsen (1972) found that self-reported study behaviors added significantly to personality measures and high school rank as predictors of grade point average (GPA). Ss in this investigation recorded study-relevant behaviors (e.g., number of uninterrupted minutes spent studying per week) for one semester, and it was noted that such data are susceptible to distortion for various reasons. Thus, a crossvalidation study using Ss' estimates of study-relevant behaviors was done which constituted a partial replication of the Allen, et al. (1972) work. This was done in order to determine whether Ss' estimates of these variables predict GPA as well as supposed records of the same events. During the eighth week of the semester 81 female and 63 male undergraduates enrolled in an introductory psychology course recorded their estimates of the following five variables: average amount of time spent studying per day, average number of interruptions during a study session, average number of days per week on which study occurred, average amount of time spent studying each time S sat down to study, and average length of each interruption. Ss also completed three measures of test anxiety: the Anxiety Differential (Husek & Alexander, 1963), Achievement Anxiety Test (Alpert & Haber, 1960), and the Test Anxiety Scale (Sarason, 1957). The Alpert scale is a composite one designed to measure the facilitating (AAT+) and debilitating (AAT-) effects of test anxiety. A stepwise multiple regression indicated the best predictor of GPA was Verbal SAT scores (R = 215). Variables which significantly increased R (McNemar, 1969, p. 321) were Effective Study Time Per Week (R = .65; F = 7.18, df = 2/135, p < .001) and AAT+ (R = .73; F = 2.61, df = 3/135, fi < .05). These results indicate that estimated self-reported study behaviors may be as useful predictors of GPA as supposedly ongoing records of same. The results further suggest the validity of using study-relevant variables and measures of test anxiety as predictors of academic performance.