Abstract

Introduction: Worldwide, interruptions to nurses are prevalent during medication administration1,2 and handoff.3 Interruptions decrease task efficiency3,4 and increase risks for errors.1-3 The use of interruption management strategies (intentional behaviors to handle interruptions) may improve the efficiency and safety of interrupted tasks.5

Purpose: To describe the investigation of the Stay SAFE interruption management strategy.

Theoretical Framework: Stay SAFE is based on the memory for goals cognitive science model5 which posits that use of associative cues (retrieval cues) when interrupted can improve task efficiency and decrease errors. Stay SAFE is an acronym for: Stay where you are, S: Stay focused on your current task, A: Associate cues, F: Find a natural break, E: Evaluate the urgency of the interruption.

Methods: A multi-methods research design was used in this study.6 Prelicensure nursing students from four US schools participated. Data were collected January-October 2024.

Participants completed a pretest and seven posttest simulations across six study visits. After the pretest, participants were taught the Stay SAFE strategy. All simulations included an interruption during medication administration. In the last four simulations, an interruption also occurred during handoff.

Trained data collectors observed and documented participants' behaviors used to manage the interruptions on a researcher-made tool. After each simulation, participants completed a checklist to indicate how they managed the interruption. The observed and self-reported data were compared to validate or correct the findings.

Participants’ perceptions of Stay SAFE were explored via semi-structured interviews. Two researchers independently read the transcribed interviews, coded the data, then collaborated to identify themes.6

Results: Fifty-one students completed all pre/posttests. During the pretest, all engaged or multitasked when interrupted. A majority (93-100%) used Stay SAFE when interrupted during the posttests. Students described Stay SAFE as easy to use, reported using Stay SAFE in hospital settings, and felt that Stay SAFE could improve the efficiency and safety of tasks. Findings were similar across study sites.

Conclusions: Interruptions decrease task efficiency and can lead to errors. Nurses and nursing students require education on how to best manage interruptions. Stay SAFE aims to improve efficiency and mitigate errors, thus it’s use may lead to improved patient care.

Notes

References:

1. Schroers G, Ross JG, Moriarty H. Nurses' Perceived Causes of Medication Administration Errors: A Qualitative Systematic Review. Jt Comm J Qual Patient Saf. 2020; 47:38-53.

2. Vanderzwan KJ, Kilroy S, Daniels A, O'Rourke J. Nurse-to-nurse handoff with distractors and interruptions: An integrative review. Nurse Educ Pract. 2023;67:103550.

3. Zhao J, Zhang X, Lan Q, Wang W, Cai Y, Xie X, et al. Interruptions experienced by nurses during pediatric medication administration in China: An observational study. J Spec Pediatr Nurs. 2019;24(4):e12265.

4. Mekonen EG, Gebrie MH, Jemberie SM. Magnitude and associated factors of medication administration error among nurses working in Amhara Region Referral Hospitals, Northwest Ethiopia. J Drug Assess. 2020;9(1):151-8.

5. Altmann EM, Trafton JG. Memory for goals: An activation-based model. Cogn Sci. 2002;26(1):39-83.

6. Polit DF, Beck CT. Nursing research: Generating and assessing evidence for nursing practice. 11 ed. Wolters Kluwer; 2021.

Description

In this presentation, audience members will gain knowledge of an innovative interruption management strategy that aims to improve task efficiency and patient safety. The strategy is actively being taught to US nurses and nursing students. Findings from a recent multisite study will be shared.

Author Details

Ginger Schroers, PHD, RN, CNE; Kathryn Vanderzwan, DNP, APRN, CHSE; Laura Klenke-Borgmann, PHD, RN, CHSE; Susan Kilroy, PHD, RN, CHSE; Jill Pfieffer, MSN, RN; Jenny O'Rourke, PHD, APRN, ANEF, FAAN

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Mixed/Multi Method Research

Keywords:

Teaching and Learning Strategies, Simulation, Interruptions, Task Efficiency, Errors, Multitasking, Stay SAFE

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Strategies for Managing Interruptions: Improving Task Efficiency and Patient Safety

Seattle, Washington, USA

Introduction: Worldwide, interruptions to nurses are prevalent during medication administration1,2 and handoff.3 Interruptions decrease task efficiency3,4 and increase risks for errors.1-3 The use of interruption management strategies (intentional behaviors to handle interruptions) may improve the efficiency and safety of interrupted tasks.5

Purpose: To describe the investigation of the Stay SAFE interruption management strategy.

Theoretical Framework: Stay SAFE is based on the memory for goals cognitive science model5 which posits that use of associative cues (retrieval cues) when interrupted can improve task efficiency and decrease errors. Stay SAFE is an acronym for: Stay where you are, S: Stay focused on your current task, A: Associate cues, F: Find a natural break, E: Evaluate the urgency of the interruption.

Methods: A multi-methods research design was used in this study.6 Prelicensure nursing students from four US schools participated. Data were collected January-October 2024.

Participants completed a pretest and seven posttest simulations across six study visits. After the pretest, participants were taught the Stay SAFE strategy. All simulations included an interruption during medication administration. In the last four simulations, an interruption also occurred during handoff.

Trained data collectors observed and documented participants' behaviors used to manage the interruptions on a researcher-made tool. After each simulation, participants completed a checklist to indicate how they managed the interruption. The observed and self-reported data were compared to validate or correct the findings.

Participants’ perceptions of Stay SAFE were explored via semi-structured interviews. Two researchers independently read the transcribed interviews, coded the data, then collaborated to identify themes.6

Results: Fifty-one students completed all pre/posttests. During the pretest, all engaged or multitasked when interrupted. A majority (93-100%) used Stay SAFE when interrupted during the posttests. Students described Stay SAFE as easy to use, reported using Stay SAFE in hospital settings, and felt that Stay SAFE could improve the efficiency and safety of tasks. Findings were similar across study sites.

Conclusions: Interruptions decrease task efficiency and can lead to errors. Nurses and nursing students require education on how to best manage interruptions. Stay SAFE aims to improve efficiency and mitigate errors, thus it’s use may lead to improved patient care.