Interruptions of activities experienced by nursing professionals in an intensive care unit

Prates, Daniele de Oliveira; Silva, Ana Elisa Bauer de Camargo

doi:10.1590/1518-8345.0997.2802

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 24 • 2016 • https://doi.org/10.1590/1518-8345.0997.2802 copy

Interruptions of activities experienced by nursing professionals in an intensive care unit^¹ 1 Paper extracted from Master's Thesis "Análise das interrupções ocorridas durante a assistência de enfermagem em Unidades de Tratamento Intensivo", presented to Faculdade de Enfermagem da Universidade Federal de Goiás, Goiânia, GO, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the interruptions experienced by nursing professionals while undertaking care activities.

Method:

an observational study undertaken in two intensive care units. Two nurses observed 33 nursing professionals for three hours. The data were recorded in real time, using a semistructured instrument.

Results:

after 99 hours of observation of 739 activities, it was identified that 46.82% were interrupted, resulting in 7.85 interruptions per hour. On average, the interruptions compromised 9.42% of the nursing professionals' worktime. The activities geared towards indirect care of the patient suffered the highest number of interruptions (56.65%), with the nursing records being the activity interrupted most. The principal source of the interruptions was external, coming from the health professionals (51%), and the main causes were those related to the patients (34.70%) and to interpersonal communication (26.47%).

Conclusion:

the activity of nursing suffers a high number of interruptions, mainly caused by the health professionals themselves, indicating that the work environment needs to undergo interventions aiming to reduce the risk of compromising of the professional's performance and to increase the patients' safety.

Descriptors:
Patient Safety; Nursing Care; Intensive Care Units; Observation

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Ana Elisa Bauer de Camargo Silva Universidade Federal de Goiás. Faculdade de Enfermagem Rua 227, Qd 68, s/n Setor Leste Universitário CEP: 74605-080, Goiânia, GO, Brasil E-mail: anaelisa@terra.com.br

Professional category	Activities	Interruptions	Proportion of interruptions by activity
Nurse	169	218	1.29
Nursing resident	127	189	1.49
Nursing technician	443	371	0.84
Total	739	778

Activities undertaken by the nursing staff	Interruption			Total of activities
	Yes		No
	N	%	N	%
Indirect patient care
Annotation/Nursing records	82	67.77	39	32.23	121
Handwashing	63	37.50	105	62.50	168
Preparation of materials for procedure	24	68.57	11	31.43	35
Preparation of medications	13	50.00	13	50.00	26
Help with the procedure	6	37.50	10	62.50	16
Communication with another professional	2	14.29	12	85.71	14
Disinfection of equipment	2	16.67	10	83.33	12
Setting up ventilator circuit	2	40.00	3	60.00	5
Discarding the patient's physiological eliminations	1	33.33	2	66.67	3
Checking tests	1	100	0	0	1
Organizing patient transport	0	0	3	100	3
Preparation of cushioning devices for reducing pressure	0	0	1	100	1
Subtotal	196		209		405
Direct patient care
Administration of medications	32	41.03	46	58.97	78
Applying dressings	24	88.89	3	11.11	27
Assessment of the patient	14	63.64	8	36.36	22
Bedbathing	11	91.67	1	8.33	12
Checking vital signs	10	27.78	26	72.22	36
Cardiac Monitoring	8	57.14	6	42.86	14
Changing position	5	27.78	13	72.22	18
Assistance with oral diet	5	35.71	9	64.29	14
Changing of items attaching endotracheal tube to patient	4	66.67	2	33.33	6
Bed-making	4	80.00	1	20.00	5
Adjusting the patient's bed	3	27.27	8	72.73	11
Collecting material	3	42.86	4	57.14	7
Endotracheal aspiration	3	42.86	4	57.14	7
Aspiration/oral and nasal hygiene	2	40.00	3	60.00	5
Administration of enteral diet	2	25.00	6	75.00	8
Intimate cleaning of the patient	2	50.00	2	50.00	4
Communication with patient/family	1	20.00	4	80.00	5
Preparation of body after death	1	100	0	0	1
Nasogastric intubation	1	100	0	0	1
Admitting the patient	1	100	0	0	1
Installation of parenteral nutrition	1	100	0	0	1
Restraining the patient	1	100	0	0	1
Oral hygiene	1	100	0	0	1
Undertaking electrocardiogram	1	100	0	0	1
Inserting Peripherally Inserted Central Catheter	1	100	0	0	1
Preparation of food	1	100	0	0	1
Subtotal	142		146		288
Administrative activity
Telephone - work use	7	15.91	37	84.09	44
Computer - work use	1	50.00	1	50.00	2
Subtotal	8		38		46
Total	346		393		739

Sources of interruptions	N	%
External Source - Human Being
Health professionals
Nursing technician	181	22.79%
Nurse	64	8.06%
Doctor	36	4.53%
Nursing resident	33	4.16%
House officer	32	4.03%
Other health professionals	27	3.40%
Bursary-funded student nurse	21	2.64%
Laboratory staff	10	1.26%
Medical students	1	0.13%
Subtotal	405	51.00%
Others
Professionals from other areas	25	3.15%
Patients	22	2.77%
Family members	4	0.50%
Subtotal	51	6.42%
External Source - Environment
Movement of persons in the environment	32	4.03%
Television	19	2.39%
Equipment (alarms, monitors)	16	2.02%
Telephone (landline)	13	1.64%
Cellphone	3	0.38%
Subtotal	83	10.45%
Internal source
Self-interruption*	255	32.12%
Subtotal	255	32.12%
Total	794	100%

Causes of the interruptions	N	%
Related to the patients	270	34.70
Interpersonal communication	206	26.47
Nursing tasks	124	15.94
Materials	56	7.19
Movement of persons in the environment	43	5.52
Telephone equipment	21	2.70
Television	19	2.44
Alarms	15	1.94
People	15	1.92
Noises	7	0.90
Others	2	0.25
Total	778	100.00