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

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

Multitarefa na unidade de recuperação pós-anestésica após interrupções da enfermagem, uma análise das causas e consequências usando a árvore de classificação: um estudo observacional prospectivo

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

Resumo

Introdução

A unidade de recuperação pós-anestésica (SRPA) é um ambiente associado a uma importante carga de trabalho suscetível de levar à interrupção de tarefas (IT), levando à alternância de tarefas ou multitarefa simultânea. O objetivo do estudo foi determinar os preditores da reação dos enfermeiros frente às IT e avaliar aqueles que levam a uma alteração da tarefa inicial.

Métodos

Realizamos um estudo observacional prospectivo na SRPA de um hospital universitário durante o mês de fevereiro de 2017. Entre 18 enfermeiras, uma selecionada foi observada a cada dia, documentando para cada IT a reação da enfermeira (mudança de tarefa ou multitarefa simultânea) e as características associadas com as IT. Foram realizadas análises de árvore de classificação usando o algoritmo C5.0 para selecionar os principais preditores do tipo de multitarefa realizada e a alteração da tarefa inicial.

Resultados

Observamos 1119 IT durante 132 horas (8,5 IT/hora). A principal reação foi multitarefa simultânea (805 IT, 72%). A curta duração da interrupção da tarefa (um minuto ou menos) foi o preditor mais importante que levou à multitarefa simultânea. Outros preditores de resposta ao IT foram a identidade do interruptor da tarefa e o número de enfermeiras presentes. Em relação às consequências da troca de tarefa, a interrupção longa (mais de cinco minutos) foi o preditor mais importante da alteração da tarefa inicial.

Conclusões

Ao analisar os preditores do tipo de multitarefa diante da IT, propomos uma nova abordagem para entender a IT, oferecendo uma nova perspectiva para estratégias de prevenção.

Palavras-chave

Simultâneo; Multitarefa; Segurança do paciente; Interrupção de tarefas; Troca de tarefas

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Submitted date:
07/09/2020

Accepted date:
05/22/2021

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