“Any improvements to minimize the number of interruptions experienced by nurses will improve healthcare quality and will help ensure patient safety.”

American River Medical Commentary – “This data directly correlates to medical cart workstation usage by nursing professionals. It identifies ‘Cumbersome processes’ which the current environment of care requires nurses to monitor, manage, and maintain the power systems on their medical carts and workstations. These ‘Cumbersome processes’ are unnecessary and distract from patient care. Thus, if innovative medical cart workstations reduce nurses’ travel paths and eliminate unnecessary interruptions enhanced patient care will be achieved which positively impacts better patient outcomes.”

“I contend available (geographically proximate and consistent), reliable, and abundantly powered medical cart workstations will enhance nursing work flow, elevate quality of patient care, reduce work place risk injury, and improve work place satisfaction. American River Medical continues to gain momentum and stakeholder buy-in on our project to innovate medical cart workstations that embody such an environment of care, possessing infinite scalability to grow with future increasing power demands on all types of medical carts.”

Tagg Neal, President – American River Medical, LLC

Knowledge Repository – The Knowledge Repository is a free user-friendly library of design resources that continues to grow with the latest research. Thank you to The Center For Health Design for making the KR free and available to all for the advancement of better healthcare. See bottom of this article for more information and a link to the KR.

Interruptions and Geographic Challenges to Nurses’ Cognitive Workload

*2009 Key Point Summary by: Terri Zborowsky

Author(s)

• Redding, D.
• Robinson, S.

Publication Source

Journal of Nursing Care Quality;

From: Knowledge Repository, The Center For Health Design

Issue 3, Pages 194 – 200

Copyright 2015 The Center for Health Design. All Rights Reserved.

Redding,D.,Robinson,S.2009|JournalofNursingCareQualityVolume24,Issue3,Pages194–200

OBJECTIVES This study set out to examine workload interruptions for nurses in medical-surgical hospital units, with the intent to identify methods for reducing interruptions and improving the nurses’ cognitive work efficiency.

Key Concepts / Contex – Inpatient care is fast-paced and requires nurses to constantly shift their attention to make clinical decisions and care for patients in a constantly environment. Nurses integrate complex thinking with psychomotor and affective skills to deliver interventions. This thinking is continually disrupted by interruptions and distractions, which compete for their attention and can lead to errors or omissions and potentially pose a risk to patient safety. Earlier studies estimate that each interruption reflected an operational loss and cost $95. The research methods used in this study replicated a prior study.

Methods – The study was conducted in medical-surgical nursing units at a 562-bed, tertiary care, urban hospital in the Midwest. The units comprised two medical units, two surgical units, and two cardiology units (one medical, one surgical). The units ranged from 30 beds (medical oncology) to 37 beds (cardiology surgical). Three of the units (medical, surgical, and cardiology medical) included intermediate care beds with invasive monitoring capacity.

The descriptive study included quantitative and qualitative observation techniques. Data collection tools included observations by two trained nurse faculty practitioners who tracked nurses’ paths on floor plans as well as kept field notes on the nurses’ actions and communication with others. A convenience sample of 32 staff nurses was observed during the day shift, working in six medical-surgical nursing units.

The study calculated interruption frequencies by type and qualitatively assessed subjects’ travel patterns to identify possible sources of interruptions and cumbersome processes interfering with patient care.

Findings – The study calculated interruption frequencies by type and qualitatively assessed subjects’ travel patterns to identify possible sources of interruptions and cumbersome processes interfering with patient care. Observers recorded 244 interruptions and found six major themes: (1) employees asking questions, (2) distracting peripheral conversations, (3) unavailable supplies that required the nurse to get them, (4) phone calls, (5) family questions, and (6) patient call lights.

Travel patterns also contributed to workflow interruptions. Nurses traveled frequently between patient rooms, medication carts or stations, and centralized equipment and care supplies locations, responding to requests from patients and other caregivers.

Reviewer note: This article discusses many findings relative to nursing unit design than can be represented here. Therefore, review of this article is recommended.

Limitations – This study is limited in that it was conducted at only one hospital where the system of care, operations, equipment, and staffing patterns may be unique to this environment. Further, the observations were all made on the day shift.

The observers did not enter patient rooms to avoid creating yet another distraction; thus, some interruptions may not have been recorded. Finally, it is possible that observers classified observations into different categories, despite their training.

Design Implications – Many interruptions occurred while nurses were in the process of performing intervention activities such as traveling to patient rooms, gathering supplies, preparing or administering medication, and patient teaching, creating a risk for medication error and the potential for unintentional omissions in care. As the authors note, “Any improvements to minimize the number of interruptions experienced by nurses will improve healthcare quality and will help ensure patient safety.”

The data from this study suggest that nurses’ travel paths on a unit create interruptions in their ability to carry out efficient patient care. Designers might consider the results of this study as they work with staff planning for their work flow. The End.

About the Knowledge Repository: The Knowledge Repository is a complete, user-friendly library of healthcare design resources that continues to grow with the latest research. Learn More Here

About The Center For Health Design: The Center for Health Design is a nonprofit 501c(3) organization whose mission is to transform healthcare environments for a healthier, safer world through design research, education and advocacy. Learn More Here

About American River Medical: American River Medical is a innovation, design and service company focused on medical cart and storage systems for healthcare. We embrace project based work, collaboration, and “Outside the box” thinking that offer opportunities to positively impact medical cart system solutions for healthcare. We fuse our experience to apply innovation where inefficiencies exist, and creativity to apply design improvements for medical cart system solutions. American River Medical is a certified Veteran Owned Small Business and a sought after diversified supplier for hundreds of healthcare systems. As a healthcare professional you’ve dedicated yourself to patient care. Our mission is to provide medical cart systems, services, and solutions that make your calling more meaningful, efficient and effective. True Solutions.

Download the Synopsis of the Key Point Summary from the Knowledge Repository here

The Marketing Research class of The W.A. Franke College of Business at Northern Arizona University in Flagstaff, Arizona, has partnered with American River Medical, LLC to conduct a marketing research study. The marketing research students will develop and field a Qualtrics online survey, and present their analysis and recommendations on American River Medical’s project and patent pending invention pertaining to “Medical Cart Mobile Power Systems” for healthcare. The research study is being overseen by Franke College of Business’s Assistant Professor of Practice, Marketing and Executive-in-Residence, Len Hostetter, and being conducted during the spring semester 2019.

Len Hostetter earned a B.S. of Business and Economics from Lehigh University as well as a M.B.A. in Marketing from The Harvard Business School. 

Taggart Neal earned a B.S. from Northern Arizona University, is a second generation Lumberjack, and has an Evidence-Based Design Accreditation and Certification (EDAC) from The Center for Health Design. 

Professor Hostetter shares, “I’m thrilled to help Tagg as an alumnus of Northern Arizona University and American River Medical in marketing research for their visionary and innovative concept for healthcare. Tagg is a recognized subject matter expert of medical carts and workstations for healthcare and we’re proud to continue to be a part of his professional development, as well as work on a project with such immense potential to positively impact healthcare sustainability, workflows, and outcomes”, says Hostetter. 

According to American River Medical President, Tagg Neal, “It is a privilege to partner with fellow Lumberjacks at NAU on one of my company’s project design concepts for healthcare. This is a first step towards understanding the environment of care without a body of data surrounding healthcare medical cart mobile power systems and the negative impact they have on healthcare professionals’ workflow, work place safety, patient outcomes, and hospitals’ sustainability goals and green initiatives. Together we will analyze the data that will either support or refine the hypothesis underlying my patent pending design for the future of medical cart mobile power systems”, shares Neal. 

NAU – The W.A. Franke College of Business – https://nau.edu/franke/

American River Medical – https://www.americanrivermedical.com/

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About American River Medical: We are Medical Carts. They are our passion, purpose, discipline, and expertise.

Medical Cart – noun, /med-i-kul – ‘kart/; “Mobile systems, solutions, or workstations that optimize the storage, mobilization, and access of healthcare equipment, supplies, medication, and electronic data.” -American River Medical, LLC

American River Medical is a innovation, design and service company focused on medical cart and storage systems for healthcare. We embrace project based work, collaboration, and “Outside the box” thinking that offer opportunities to positively impact medical cart system solutions for healthcare. We fuse our experience to apply innovation where inefficiencies exist, and creativity to apply design improvements for medical cart system solutions. American River Medical is a certified Veteran Owned Small Business and a sought after diversified supplier for hundreds of healthcare systems. As a healthcare professional you’ve dedicated yourself to patient care. Our mission is to provide medical cart systems, services, and solutions that make your calling more meaningful, efficient and effective. True Solutions.