title: Effectiveness of an improvement programme to prevent interruptions during medication administration in a paediatric hospital: a preintervention-postintervention study.
abstract: To assess the effectiveness of an improvement programme to reduce the number of interruptions during the medication administration process in a paediatric hospital.
  
  
  
  A prestudy-post study design was used to monitor nursing interruptions during medication cycles in a paediatric hospital. Interruptions were reported on an observation sheet (MADOS-P) adapted to the paediatric context.
  
  
  
  A 600-bed tertiary paediatric research hospital in Italy.
  
  
  
  The interventions included a yellow sash worn by nurses during medication cycles, a yellow-taped floor area indicating the 'No interruption area', visual notices in the medication areas, education sessions for healthcare providers and families, patient and parent information material.
  
  
  
  225 medication cycles were observed before the intervention (T0) and 261 after the intervention (T1). The median of interruptions occurring in each cycle decreased significantly from baseline to postintervention (8.0 vs 2.0, p=0.002), as the rate ratios (interruptions/patient post-pre ratio: 0.34; interruptions/medication post-pre ratio: 0.37; interruptions/hour of medication cycle post-pre ratio: 0.53, p<0.001). During preintervention, the main causes of interruptions were 'other patients' (19.9%), 'other nurses' (17.2%) and 'conversation' (15.7%); during postintervention, they were 'other nurses' (26.1%), 'conversation' (18.2%) and 'other patients' (17.4%).
  
  
  
  This bundle of interventions proved to be an effective improvement programme to prevent interruptions during medication administration in a paediatric context.
authors.affiliation: Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Immacolata
authors.initials: I
authors.lastname: Dall'Oglio
authors.affiliation: Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Fiori
authors.affiliation: Epidemiology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Ciommo
authors.affiliation: Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Tiozzo
authors.affiliation: Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Rachele
authors.initials: R
authors.lastname: Mascolo
authors.affiliation: Nursing Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Natalia
authors.initials: N
authors.lastname: Bianchi
authors.affiliation: Epidemiology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Marta Luisa
authors.initials: ML
authors.lastname: Ciofi Degli Atti
authors.affiliation: Master of Nursing Sciences, Tor Vergata University, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Ferracci
authors.affiliation: Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Orsola
authors.initials: O
authors.lastname: Gawronski
authors.affiliation: Organization and Quality Nursing Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pomponi
authors.affiliation: Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Raponi
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D002648:Child; D004358:Drug Therapy / Q000451:nursing*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008510:Medication Systems, Hospital / Q000592:standards; D009732:Nursing Care / Q000379:methods; D015403:Nursing Evaluation Research; D015588:Observer Variation; D064872:Patient Care Bundles; D057184:Practice Patterns, Nurses'