Interruptions were studied extensively in the past but with a focus on their negative effects. Although many types of interruptions result in a break-in-task, in some cases interruptions communicate important information associated with patient’s safety. The majority of previous interruption research use a reductionist approach to minimize or prevent interruptions, and minimal attention has been given to the differentiation between positive and negative interruptions. Through the analysis of relevant healthcare literature, this paper first identifies the inconsistencies in the way interruptions are defined, and then categorizes potential sources of negative and positive interruptions.
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References
1.
AllardJ.WyattJ.BleakleyA.GrahamB. (2011). “Do you really need to ask me that now?”: a self-audit of interruptions to the ‘shop floor’ practice of a UK consultant emergency physician. Emerg Med Journal.
2.
AlvarezG.CoieraE. (2005). Interruptive communication patterns in the intensive care unit ward round. International Journal of Medical Informatics.74:791–796.
3.
AnthonyK.WiencekC.BauerC.. (2010). No interruptions please: impact of a No Interruption Zone on medication safety in intensive care units. Crit Care Nurse, 30:21-9.
4.
BaileyB. P.KonstanJ. A. (2006). On the need for attention- aware systems: Measuring effects of interruption on task performance, error rate, and affective state, Computers in Human Behavior,22 (4), 685-708
5.
BlumN. J.LieuT. A. (1992). Interrupted Care - the Effects of Paging on Pediatric Resident Activities. American Journal of Diseases of Children.146: 806–808.
6.
BrixeyJ. J.ZhangJ.JohnsonT. (2003). Analysis of Interruptions in Healthcare. Paper presented at the Proceedings of AMIA, in review.
7.
BrixeyJ. J.RobinsonD. J.JohnsonC. W.. (2007). A concept analysis of the phenomenon interruption. ANS Adv Nurs Sci. 30: E26–E42.
8.
CellierJ. M.EyrolleH. (1992). Interference between switched tasks. Ergonomics, 35, 25–36.
9.
ChisholmC. D.CollisonE. K.NelsonD. R.CordellW. H. (2000). Emergency Department Workplace Interruptions Are Emergency Physicians “Interrupt-driven” and “Multitasking”?. Academic Emergency Medicine, 7: 1239–1243.
10.
CoieraE. W.JayasuriyaR. A.HardyJ.. (2002). Communication loads on clinical staff in the emergency department. Med J Aust. 176:415–418.
11.
CollinsS. A.CurrieL.PatelV. L.BakkenS.CiminoJ. J. (2007). Multi-tasking by clinicians in the context of CPOE and CIS use, in: Congress Proceedings Med Info, Brisbane, Australia, 2007, 958–962.
12.
CzerwinskiM.CutrellE.HorvitzE. (2000). Instant Messaging and Interruption: Influence of Task Type on Performance. Proceedings of OZCHI 2000, 356-361.
13.
DeardenA.SmithersM.ThaparA. (1996). Interruptions during general practice consultations - The patients’ view. Family Practice. 13:166–169.
14.
DrewsF. A. (2007). The frequency and impact of task interruptions on patient safety in the ICU; Human Factors and Ergonomics Society 51st Annual Meeting; Baltimore, MD: Human Factors and Ergo-nomics Society. 683–686.
15.
EbrightP. R.PattersonE. S.ChalkoB. A.RenderM. L. (2003). Understanding the complexity of registered nurse work in acute care settings, J. Nurs. Adm. 33 (12):630–638.
16.
FriedmanS.ElinsonR.ArenovichT. (2005). A Study of Emergency Physician Work and Communication: A Human Factors Approach. Israel Journal of Emergency Medicine. 5:35–42.
17.
FairbanksR. J.BisantzA. M.SunmM. (2007) Emergency department communication links and patterns, Ann. Emerg. Med. 50 (4):396– 406.
18.
FranceD. J.LevinS.HemphillR.. (2005). Emergency physicians’ behaviors and workload in the presence of an electronic white-board. Int J Med Inform. 74:827-837.
HarveyR.JarrettP. G.PeltekianK. M. (1994). Patterns of Paging Medical Interns During Night Calls at 2 Teaching Hospitals. Canadian Medical Association Journal. 151:307–311.
21.
HealeyA. N.SevdalisN.VincentC. A. (2006). Measuring intra-operative interference from distraction and interruption observed in the operating theatre. Ergonomics. 49:589–604.
22.
HealeyA. N.PrimusC. P.KoutantjiM. (2007). Quantifying distraction and interruption in urological surgery. Quality & Safety in Health Care. 16:135–139.
23.
HedbergB.LarssonU. S. (2004). Environmental elements affecting the decision-making process in nursing practice. Journal of Clinical Nursing. 13:316–324.
24.
HillelG.VicenteK. J. (2003). Nursing interruptions in a post-anesthetic care unit: a field study, in: Proceedings of the Human Factor and Ergonomics Society 47th Annual Meeting, Denver, CO,1443– 1447.
25.
HymelG.SeverynF. (1999). Typical shiftwork interruptions faced by supervising EM faculty in an EM residency setting [abstract]. In: Society for Academic Emergency Medicine Midwest Regional Meeting, Ann Arbor, MI, Sept 1999.
26.
JCAHO. (2001). A follow-up review of wrong site surgery. In: Sentinel Event Alert.
JettQ. R.GeorgeJ. M. (2003). Work interrupted: A closer look at the role of interruptions in organizational life. Academy of Management Review. 28:494–507.
29.
JiwaM.McKinleyR.O’SheaC.ArnetH.SpilsburyK.SmithM. (2009). Investigating the impact of extraneous distractions on consultations in general practice: Lessons learned. BMC Medical Research Methodology2009, 9:8
30.
KohnL.CorriganJ.DonaldsonM. (eds.) (1999). To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press.
31.
KositsL.JonesK. (2011). Interruptions experienced by registered nurses working in the emergency department. J Emergency Nurs. 37(2): pp. 3-8.
32.
LaxmisanA.HakimzadaF.SayanO. R.. (2007). The multitasking clinician: Decision-making and cognitive demand during and after team handoffs in emergency care. International Journal of Medical Informatics. 76:801–811.
33.
LearyJ.GallagherT.CarsonJ.FaginL.BartlettH.BrownD. (1995). Stress and coping strategies in community psychi- atric nurses: a Q-methodological study. J Adv Nurs. 21: 230–7.
34.
McFarlaneD. C. (2002). Comparison of four primary methods for coordinating the interruption of people in human-computer interaction, Human-Computer Interaction, 17 (1), 63-139
35.
McGillis-HallL.. (2011). Interruptions and pediatric patient safety. J Pediatr Nurs, in press.
36.
MossJ.BernerE.BotheO.RymarchukI. (2008). Intravenous medication administration in intensive care: opportunities for technological solutions. AMIA Annu Symp Proc. 495-499.
37.
PapeT. M. (2003). Applying airline safety practices to medication administration. MEDSURG Nursing. 12:77–94.
38.
PapeT. M.GuerraD. M.MuzquizM.. (2005). Innovative approaches to reducing nurses’ distractions during medication administration. J Contin Educ Nurs. 36:108–116. quiz 41-2.
39.
PelegR.FroimoviciM.PelegA.. (2000). Interruptions to the physician-patient encounter: An intervention program. Israel Medical Association Journal. 2: 520–522.
40.
PereiraB. M. T.PereiraA. M. T.CorreiaC. S.MarttosA. C.JrFiorelliR. K. A.PereiraF. G. (2011). Interrupções e distrações na sala de cirurgia do trauma: entendendo a ameaça do erro humano. Revista do Colégio Brasileiro de Cirurgiões, 38(5), 292-298.
41.
PersoonM. C.BroosH. J.WitjesJ. A.HendrikxA. J.ScherpbierA. J. (2011). The effect of distractions in the operating room during endourological procedures. Surgical endoscopy [2011, 25(2):437-43]
42.
PotterP.BoxermanS.WolfL.. (2004). Mapping the nursing process: a new approach for understanding the work of nursing. J Nurs Adm. 34:101–109.
43.
PotterP.WolfL.BoxermanS.. (2005). Understanding the cognitive work of nursing in the acute care environment. J Nurs Adm. 35:327–335.
44.
RelihanE.O’BrienV.O’HaraS.SilkeB. (2010). The impact of a set of interventions to reduce interruptions and distractions to nurses during medication administration. Quality & Safety in Health Care, 19(5), 1-6.
45.
SevdalisN.ForrestD.UndreS.. (2008). Annoyances, disruptions, and interruptions in surgery: The Disruptions in Surgery Index (DiSI)World Journal of Surgery. 32:1643–1650.
46.
ShvartzmanP.AntonovskyA. (1992). The Interrupted Consultation. Family Practice. 9:219–221.
47.
SpencerR.CoieraE.LoganP. (2004). Variation in communication loads on clinical staff in the emergency department. Ann Emerg Med. 44:268–273.
48.
StevensonJ.G. (2005). Medication errors: Experience of the United States Pharmacopeceia (USP)’. Journal of Quality and Patient Safety31(2): 114-119.
49.
TraftonJ. G.AltmannE. M.BrockD. P.MintzF. E. (2003) Preparing to resume an interrupted task: Effects of prospective goal encoding and retrospective rehearsal, International Journal of Human-Computer Studies, 58 (5):583-603
50.
TrbovichP.PrakashV.StewardJ.TripK.SavageP. (2010). Interruptions During the Delivery of High Risk Medications. The Journal of Nursing Administration, 40, 211-218.
51.
TuckerA. L.SpearS. J. (2006). Operational failures and interruptions in hospital nursing. Health Serv Res. 41:643–662.
52.
Van BergenA. (1968). Task Interruption. Amesterdam: North- Holland Publishing Company
53.
WestbrookJ. I.AmptA.KearneyL.. (2008). All in a day’s work: an observational study to quantify how and with whom doctors on hospital wards spend their time. Medical Journal of Australia. 188:506–509.
54.
WiegmannD. A.ElBardissiA. W.DearaniJ. A.. (2007). Disruptions in surgical flow and their relationship to surgical errors: An exploratory investigation. Surgery. 142:658–665.
55.
WoloshynowychM.DavisM.BrownR.VincentC. (2007). Communication patterns in a UK emergency department, Ann. Emerg. Med. 50 (4):407–413.
