title: Paradoxical effects of a hospital-based, multi-intervention programme aimed at reducing medication round interruptions.
abstract: OBJECTIVE
  The main aim of the present study was to evaluate interruptions that occurred during medication rounds within a hospital-based, multi-intervention programme.
  
  
  BACKGROUND
  There are no standardized ways to reduce medication interruptions during medication rounds and no guidelines or standards on the use of tabards during medication rounds.
  
  
  METHODS
  In 2006, a preliminary baseline evaluation (T0) was conducted at the hospital level observing the occurrence of interruptions during medication rounds in daily practice. Subsequently, a hospital-based policy for a multi-intervention medication round programme was implemented at of the beginning of 2008 (T1). After 18 months, an evaluation of the frequency of interruptions was repeated (T2).
  
  
  RESULTS
  At T0, 298 interruptions were observed for 945 medications administered, or one for every 3.2 medications given. At T2, 385 interruptions were observed for 895 medications given, an interruption for every 2.3 medications administered (P = 0.041). At T0, the mean interruption duration per medication round was 10.48 min whereas at T2 it was 5.08 min. Patient interruptions were reduced (26.5-14.0%, P = 0.05); in spite of this effect, staff member interruptions increased (15.8-40.5%, P = 0.01).
  
  
  CONCLUSIONS
  With the implementation of the multi-intervention programme, the interruptions changed their pattern. While wearing the red tabard was paradoxically effective with patients, it was ineffective with other staff members.
  
  
  CONCLUSIONS
  Before introducing new strategies, an evaluation of their appropriateness with regard to the culture of the patients and nurses is recommended: in the present study, patients seem to have considered the warning message worn by nurses as mainly intended for them.
authors.affiliation: School of Nursing, Udine University, Udine, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Tomietto
authors.forename: Arianna
authors.initials: A
authors.lastname: Sartor
authors.forename: Elisa
authors.initials: E
authors.lastname: Mazzocoli
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
mesh_terms: D001288:Attention; D004358:Drug Therapy / Q000451:nursing*; D006801:Humans; D007400:Interprofessional Relations; D008508:Medication Errors / Q000517:prevention & control*; D009723:Nurse-Patient Relations; D015401:Nursing Administration Research; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D015279:Organizational Culture; D061214:Patient Safety; D017751:Safety Management / Q000458:organization & administration*