Response to Jean Smith

********* please respind to the discussion below add citations and references 😉 *********

The use of evidence-based practice has increased and has become the standard for healthcare decision making. It is a key element for clinical decision making and the provision of quality care. The use and interpretation of statistics plays a critical role in the development of evidence-based nursing practice (Giuliano & Polanowicz, 2008), therefore an understanding of the fundamentals of statistical analysis is a necessary skill for the nurse to participate in and interpret research studies both for accuracy and validity.

We all can agree that patient safety is paramount and that we are duty bound to protect patients from injury as well as to participate in activities and adhere to standards that are based in evidence to maintain or improve health. Our facility participated in a multi-organizational study that focused on medication errors (both actual medication errors, near misses, and the timeliness of administered medications) due to nursing distraction during a med-pass. This was done only on in-patient units and excluded specialty areas such as the OR, the ED, and the ambulatory surgical unit. The findings demonstrated that nursing distraction from phone-calls from family members of patients, calls to the pharmacy for missing medications, noise, phone calls from physicians, and other practitioners interrupting the nurse while administering medications, contributed to errors in administration and the timeliness of administered medications. In addition, nurses were distracted from task by call bells and having to stop a med-pass to provide care such as toileting. In response to this safety issue, several interventions to limit nursing distraction were implemented. Med-pass is considered a “sacred” time. Phone calls are answered by the unit clerk and messages are given to the nurse after the med-pass for return calls to physicians or family members. A patient care device (cell phone) is available to the nurse so that other practitioners can communicate without interrupting the nurse. Overhead pages are limited and only permitted in emergent situations such as a rapid response or a code 99. Interruptions are not permitted when a nurse is obtaining medications from Omnicell. Patient care technicians are made aware by the primary nurse when a med-pass is begun and are instructed to answer all call bells and round on patients in their zone. Pharmacy has a 10- minute window in which to approve new medication orders and deliver medications needed via a pneumatic tube. A facility in our immediate area instituted an intervention where the nurse’s zone is literally taped off during a med-pass so as not to be distracted or interrupted during a med-pass. Although our facility has not adopted this practice, we are always looking to see what other facilities are doing to address nursing distraction during medication administration.

References

Giuliano, K. K., & Polanowicz, M. (2008). Interpretation and use of statistics in nursing research. Advanced Critical Care, 19, 211-222. Retrieved from www.researchgate.net/publication/5295040_Interpret…

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