Class Report #2 Hypothesis: The establishment of a No Interruption Zone during medication preparation decreases unnecessary interruptions thereby increasing

patient safety. Imagine being in the middle of following the directions of a recipe for a pound cake and suddenly the phone rings. You answer the phone and spend 10 minutes in the conversation before returning to the task of preparing the cake batter. You look in the mixing bowl of the dry ingredients and now you cant remember if you added the salt before the phone rang. You have a couple of options: start over; add the salt to the dry mixture; or assume you added the salt before the phone rang. Regardless of the option you choose, the results are inconsequential: lost time or a funny tasting pound cake. Now imagine being a nurse in an intensive care unit, responsible for administering medications to patients. You are in the process of administering a medication to a patient through an intravenous solution when another nurse enters the room to ask you a question. After she leaves, you cannot remember the dosage you administered to the patient. Unlike the cake batter scenario, the result of the option you choose is consequential and can be life-threatening. In their study, Impact of a No Interruption Zone on Medication Safety in Intensive Care Units, K. Anthony, Wiencek, Bauer, Daly and M. Anthony imply that during medication preparation, a No Interruption Zone could decrease interruptions and enhance safety. The idea for establishing a No Interruption Zone (NIZ) during the process of medication preparation and administration is based on the aviation industrys sterile cockpit rule. Under this rule, pilots are prohibited from performing nonessential tasks and participating in communications unrelated to flight operations below 10,000 feet.

The 10,000 feet standard is important because this is the height where take-off and landing operations, the most complex tasks of aviation, occur. The researchers conducted this study in two ICUs: a 20-bed medical ICU and a 20-bed surgical ICU. The research team chose an ICU staff nurse as the data collector; however, in order to prevent the nurses on duty from modifying their normal behavior, the researchers did not inform them about the nature of the study. The data collection occurred in three phases. Phase I was a one week observation and data collection period. Phase II introduced the NIZ, red duct tape place around medication carts and medication administration areas. The day prior to the NIZ implementation, the nurses and other clinical staff were briefed on the purpose of the NIZ. The nurses were given a threeweek period to get accustomed to the NIZ. Phase III occurred during the fourth week and once again the data collector recorded her observations. At the end of the study the Phase I and Phase III collected data were compared to each other. K. Anthony, Wiencek, Bauer, Daly and M. Anthony accepted the implied hypothesis. They concluded that an NIZ can reduce interruptions during medication preparation. The results of their experiment showed a 40.9% decrease in interruptions after the implementation of the NIZ. They recommended further investigation to determine if these results are sustainable and what other areas besides the medication cart should be included in the NIZ. Proper medication administration is a critical aspect of a nurses duties and this duty must be conducted in a manner that always keeps its life or death consequences foremost in the mind of the nurse. Drugs that have life-saving properties can easily become a patients death sentence when given in the wrong amount. Nurses must always make

patient safety a top priority and adopt a zero-tolerance for unnecessary interruptions during medication administration. The establishment of NIZs in hospitals serves as an important reminder to nurses of the severe consequences of improper medication administration.