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September 2012, Volume 42 Number 9 , p 18 - 21


  • Dawn Elizabeth Klejka MSN, RN


NURSES EXPERIENCE many interruptions and distractions during medication administration. Medication carts are commonly located in bustling hallways on busy nursing units; many are directly across from the central nurses' station, a hub of activity. Nurses often prepare medications close to these central stations, and this proximity can be very distracting. Several research studies have shown that interruptions and distractions any time during the medication administration process can cause life-threatening medication errors.1-3Other research has identified successful strategies for decreasing these dangerous disruptions, including "Quiet Zone" signage, red-taped areas around medication carts, and a medication administration safety checklist.4,5A Quiet Zone pilot study was conducted at Excela Health Westmoreland Hospital in Greensburg, Pa., a rural community hospital. This article describes how the study was conducted and what strategies were implemented to stop interruptions and distractions and to heighten awareness of the danger to patient safety. The first step was examining the evidence.A review of the nursing literature indicates that a nurse shouldn't be interrupted or distracted when engaged in any part of the medication administration process: retrieving, preparing, administering, or documenting medications. Nursing interruptions and distractions any time during the process can result in medication errors, threatening patient safety.1The evidence examining interruptions to nurses' work included systematic reviews and primary studies conducted internationally. Westbrook et al. conducted an observational study of nurses in two hospitals preparing and administering medications in six wards and concluded, "The occurrence and frequency of interruptions were significantly associated with the incidence of procedural failures and clinical errors."1 A procedural failure occurs when a nurse fails to follow the medication administration procedure or the medication safety

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