Table of Contents
Implications for Practice
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Patient care requires considerable concentration and mindfulness from medical staff. However, a quick working process in hospitals involves many distractions. This problem has negative consequences for some tasks affecting the patient’s health. For example, during a drug round, interruptions and medication administration errors (MAEs) may occur. The purpose of the research is to study the effectiveness of such a method of solving this distraction problem during drug rounds as the use of tabards.
To achieve the research goal, mixed methods before-after study were used, including three observation periods in a hospital, interviews with participants, and a focus group. Observations took place before the implementation of tabard – the first period, two weeks after – the second period, and four months later – the third (Verweij et al., 2014). It was found that using tabards significantly reduces the likelihood of both MAEs and interruptions.
The main study’s finding is the proven effectiveness of using drug round tabards to prevent interruptions and MAEs. Thanks to them, the main distraction factor was minimized – conversations with colleagues. Although participating nurses were final phase students, they were trained and skilled enough to make observations clear. The introduction of tabards can make a significant contribution to the rate of recovery of patients. This innovation requires some changes in the working processes of the hospital and its rules.
Potential problems that may arise during the introduction of tabards have also been found – a negative attitude towards them of nurses and patients. The doubts of medical personnel about the use of drug round tabards have reasons, but they can be solved with some adaptive measures. The problem of using bright yellow, which repelled patients and prevented them from asking questions, can be changed to a more acceptable one within the hospital walls. The solution to the hygiene problem, which concerns nurses, lies in introducing new rules for cooperation with laundry workers. The effectiveness and benefits of using tabards are greater than the effort invested in them.
Moreover, the research found linearity between interruptions and MAEs – the first has an impact on the second’s appearance. However, the association between these phenomena is not as strong as found in the study by Biron et al. (2009). This fact indicates that other factors provoke MAEs and those that can reduce their likelihood, for example, involving ward managers in the process. This aspect of the research has a limitation that may affect the results – the tabards study could create conditions for nurse follow-up, giving an additional boost to concentration.
Implications for Practice
Information obtained during the study can be offered to medical institutions as an incentive to introduce drug round tabards. The responses and suggestions received from the focus group of nurses can prevent the appearance of some obstacles and make the process of moving to the use of such a measure easier and faster. Moreover, the results can serve to create newsletters and training materials on the importance of drug round tabards.
This study may also provide ground for further researches on the connections between interruptions and MAEs, and other factors influencing their appearance and reduction. Furthermore, while the study proves the benefit of preventive measures, scientists question the effectiveness of any interventions. For example, Raban and Westbrook (2014) believe that evidence of the benefit of such measures is not strong enough to conduct them. They point out that the studies they reviewed predominantly used multiple interventions. For this reason, future research should focus on individual-specific factors influencing MAEs.
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The proposed method of reducing distractions in the form of drug round tabards also requires further study. Medical personnel’s concern about the perception of such warning signals by patients, as well as many negative responses from nurses, suggest the need to find better ways to implement this measure. New research could aim to develop strategies for staff collaboration to implement tabards to make them convenient for both nurses and patients.
Thus, the study of the intervention’s effectiveness, such as the use of tabards to prevent nurse distraction and reduce the likelihood of MAEs, proves the benefit of this strategy. Further study is required to develop ways to implement it and other methods of intervention to prevent errors in the drug round process. Some of the existing studies prove that such measures are ineffective, which contradicts this study and provides reasons for new observations.
Biron, A. D., Loiselle, C. G., & Lavoie-Tremblay, M. (2009).Work interruptions and their contribution to medication administration errors: An evidence review. Worldviews on Evidence-Based Nursing, 6(2), 70–86.
Raban, M. Z., & Westbrook, J. I. (2014). Are interventions to reduce interruptions and errors during medication administration effective?: Asystematic review. BMJ Quality & Safety, 23(5), 414-421.
Verweij, L., Smeulers, M., Maaskant, J. M., &Vermeulen, H. (2014). Quiet please! Drug round tabards: Are they effective and accepted? A mixed method study. Journal of Nursing Scholarship, 46(5), 340-348.