اختلال کاری پرستاران در طول پروسه مدیریت دارو ها و عوامل مرتبط با آن Work Interruption Experienced by Nurses during Medication Administration Process and Associated Factors, Northwest Ethiopia

1. Background Patient safety is a key aspect in the care of the patients and one of the dimensions to determine the quality of care [1, 2]. Medication errors have been identified as one of the most common type of errors affecting patient safety, ranging from 42 to 59% of all medical errors [3]. The nursing medication administration process involves the preparation, administration, and documentation in a continuous process through a series of actions without interruption [4– 7]. However, the medication administration process remains the most interrupted nursing activity globally [8, 9]. Work interruptions (WIs) are a break in the continuity of task performance [10] and result in the task being unexpectedly suspended at some step prior to completion [11] due to distraction or intrusion of unplanned secondary tasks or demands [7, 12, 13]. Studies revealed that work interruptions during medication administration rounds are thought to be a prominent factor in medication errors that account for up to 43% of medication errors [14]. Studies showed that nurses are interrupted at a rate of 5.5 to 14 work interruptions/hr [15, 16], these causing a high level of inefficiency as nursing was not meeting its goal of delivering all medication within 60 minutes of prescribed acceptable time and creating a significant risk that distracted/interrupted nurses leading to them making mistakes or errors [17]. Work interruptions during the medication administration process usually lead to clinical errors in nursing practice with up to 88.9% having negative consequences [18]. Work interruptions also associated with a 12.1% increase in procedural failures and a 12.7% increase in clinical errors [19] and contributed to an average of 2.1- hour time loss per day, and the subsequent lost productivity cost to economy was $588 billion dollars per year from the general working environment [20, 21]. Beyond its effects on patient safety and resources, work interruptions also affect the general well-being of employees [22], for example, increased anxiety, stress, and dissatisfaction, and contribute to high workload [11, 22]. Evidence showed that work interruptions result from self-initiation (the individual nurse him/herself on the medication administration process task), other persons’ initiation, system failure (missing medications, missing equipment), environmental noise, and occurrence of emergency situation in the nursing environment; work experience was associated with work interruptions [23].