Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.05.013
Brazilian Journal of Anesthesiology
Clinical Research

Multitasking in postanesthesia care unit following nurse interruptions, an analysis of the causes and consequences using classification tree: an observational prospective study

Charles-Hervé Vacheron, Olivier Peyrouset, Pascal Incagnoli, Virginie Charra, Stéphanie Parat, Jean-Stephane David, Alexandre Theissen, Vincent Piriou, Arnaud Friggeri

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Abstract

Background
Postanaesthesia care unit (PACU) is an environment associated with an important workload which is susceptible to lead to task interruption (TI), leading to task-switching or concurrent multitasking. The objective of the study was to determine the predictors of the reaction of the nurses facing TI and assess those who lead to an alteration of the initial task.

Methods
We conducted a prospective observational study into the PACU of a university hospital during February 2017. Among 18 nurses, a selected one was observed each day, documenting for each TI the reaction of the nurse (task switching or concurrent multitasking), and the characteristics associated with the TI. We performed classification tree analyses using C5.0 algorithm in order to select the main predictors of the type of multitasking performed and the alteration of the initial task.

Results
We observed 1119 TI during 132 hours (8.5 TI/hour). The main reaction was concurrent multitasking (805 TI, 72%). The short duration of the task interruption (one minute or less) was the most important predictor leading to concurrent multitasking. Other predictors of response to TI were the identity of the task interrupter and the number of nurses present. Regarding the consequences of the task switching, long interruption (more than five minutes) was the most important predictor of the alteration of the initial task.

Conclusions
By analysing the predictors of the type of multitasking in front of TI, we propose a novel approach to understanding TI, offering new perspective for prevention strategies.

Keywords

Concurrent;  Multitasking;  Patient safety;  Task interruption;  Task switching

References

1 Institute of Medicine (US) Committee on Quality of Health Care in America To Err is Human: Building a Safer Health System National Academies Press (US), Washington (DC), http://www.ncbi.nlm.nih.gov/books/NBK225182/ (2000) (accessed 27 Sep 2019)

2 J. Reason Human Error by James Reason Camb. Core (1990), 10.1017/CBO9781139062367

3 ELJ van Rensen, EST Groen, SC Numan, et al. Multitasking during patient handover in the recovery room Anesth Analg, 115 (2012), pp. 1183-1187

4 H. Pashler, P. Jolicœur, R. Dell’Acqua, et al. Task switching and multitask performance Control of cognitive processes: Attention and performance XVIII, The MIT Press, Cambridge, MA, US (2000), pp. 275-423

5 S. Deprez, M. Vandenbulcke, R. Peeters, et al. The functional neuroanatomy of multitasking: combining dual tasking with a short term memory task Neuropsychologia., 51 (2013), pp. 2251-2260

6 S.R. Walter, L. Li, W.T.M. Dunsmuir, et al. Managing competing demands through task-switching and multitasking: a multi-setting observational study of 200 clinicians over 1000 hours BMJ Qual Saf., 23 (2014), pp. 231-241

7 J.I. Westbrook, M.Z. Raban, S.R. Walter, et al. Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study BMJ Quality & Safety., 27 (2018), pp. 655-663

8 E.A. Flynn, K.N. Barker, J.T. Gibson, et al. Impact of interruptions and distractions on dispensing errors in an ambulatory care pharmacy Am J Health-Syst Pharm AJHP Off J Am Soc Health-Syst Pharm., 56 (1999), pp. 1319-1325

9 J.I. Westbrook, A. Woods, M.I. Rob, et al. Association of interruptions with an increased risk and severity of medication administration errors Arch Intern Med., 170 (2010), pp. 683-690

10 A.J. Rivera-Rodriguez, B.-T. Karsh Interruptions and distractions in healthcare: review and reappraisal BMJ Qual Saf., 19 (2010), pp. 304-312

11 L.M. Berg, A.-S. Källberg, K.E. Göransson, et al. Interruptions in emergency department work: an observational and interview study BMJ Qual Saf., 22 (2013), pp. 656-663

12 G. Campbell, K. Arfanis, A.F. Smith Distraction and interruption in anaesthetic practice Br J Anaesth, 109 (2012), pp. 707-715

13 F.A. Drews, B.A. Markewitz, G.J. Stoddard, et al. Interruptions and Delivery of Care in the Intensive Care Unit Hum Factors., 61 (2019), pp. 564-576

14 D.M. Sanbonmatsu, D.L. Strayer, N. Medeiros-Ward, et al. Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking PLOS ONE, 8 (2013), Article e54402

15 SK Powell Mindfulness, Multitasking, and You Prof Case Manag., 21 (2016), pp. 61-62

16 D Rohrer, HE Pashler Concurrent task effects on memory retrieval Psychon Bull Rev., 10 (2003), pp. 96-103

17 M. Nijboer, N.A. Taatgen, A. Brands, et al. Decision making in concurrent multitasking: do people adapt to task interference? PloS One., 8 (2013), Article e79583

18 JP Borst, NA Taatgen, H van Rijn The problem state: a cognitive bottleneck in multitasking J Exp Psychol Learn Mem Cogn., 36 (2010), pp. 363-382

19 J.S. Rubinstein, D.E. Meyer, J.E. Evans Executive control of cognitive processes in task switching J Exp Psychol Hum Percept Perform., 27 (2001), pp. 763-797

20 M Weigl, A Müller, S Holland, et al. Work conditions, mental workload and patient care quality: a multisource study in the emergency department BMJ Qual Saf, 25 (2016), pp. 499-508

21 JA Freischlag The operating room dance BMJ Quality & Safety, 21 (2012), p. 1

22 J Bezemer, A Cope, T Korkiakangas, et al. Microanalysis of video from the operating room: an underused approach to patient safety research BMJ Qual Saf, 26 (2017), pp. 583-587

23 H.E. Douglas, M.Z. Raban, S.R. Walter, et al. Improving our understanding of multi-tasking in healthcare: Drawing together the cognitive psychology and healthcare literature Appl Ergon., 59 (2017), pp. 45-55
 

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