Date of Graduation

12-11-2020

Document Type

Project/Capstone

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Cathy Coleman, DNP, RN, MSN, CNL, CPHQ

Second Advisor

David Ainsworth, MSN, RN, CNL

Abstract

Background: Interruptions occur in high frequency in the critical care hospital setting.

The purpose of this study is to understand the impact of work interruption for the critical care nurse and to examine ways to mitigate predominant, non-urgent interruptions.

Methods: The nurse interrupted project followed the Lean methodology framework to identify which high-frequency interrupters to address. Baseline assessment of the intensive care unit (ICU) nurses identified alarms and patient family member calls as predominant causes of interruption. A literature review was conducted to understand work interruption for nurses and to identify available solutions.

Intervention: To address the volume of incoming calls, daily out-bound calls were made by nurses to update family members and expectations were set for the next update. Daily electrode lead changes were completed to reduce clinically non-relevant alarms. Improvement huddles were completed daily by unit ICU nurses identified as stakeholders in this project.

Results: During a 4-week implementation period, 20-day shifts were monitored and found a 12.03% reduction of in-bound calls from family members. Data points showed a trend indicating the test of change was effective. Daily electrode lead change had a 62.2% reduction in leads off alarms (894 events to 338). However, cannot analyze alarm events increased four weeks post-intervention, followed by 21.9% reduction at eight weeks post-intervention.

Conclusions: Nurse leaders should implement workflow conducive to limiting non-urgent interruptions and educate nurses on how to mitigate interruptions that may cause patient harm or impair care experience.

Keywords: nurse interruption, patient satisfaction, work interruption, patient safety, nursing workflow

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