Calls to Nurses’ Phones May Increase Risk of Medication Errors

Recent research suggests that nurses may be more likely to make medication errors around the time they receive phone calls. 

Christopher P. Bonafide and colleagues recently published a study (1) in JAMA Pediatrics, focused on mobile telephone interruptions in a pediatric intensive care unit (PICU). This study included 257 nurses and 3308 patients, and considered incoming calls and text messages to nurses’ hospital-assigned cell phones that occurred in the 10 minutes before a nurse attempted to administer medication. It also considered the following:

  • The nurse’s experience in the PICU 
  • The nurse’s shift (day or night)
  • The level of care that patients needed
  • The nurse-to-patient ratio

Information on medication errors was taken both from reported mistakes, as well as bar code medication administration error alerts. The latter occurred when nurses tried to give medications without having an order for the patient’s bar code that they scanned.

Results: multiple factors increase the risk of medication errors surgery 79584 1920

Bonafide and colleagues found that incoming calls to nurses’ cell phones appeared to increase the risk of medication errors. The risk of medication errors was also heightened for nurses who had fewer than six months of experience or who were working at night. The severity of patients’ conditions and the nurse-to-patient ratio also appeared to have some impact on risk. Nurses were more likely to make errors when they were responsible for administering medications to at least two patients who were receiving mechanical ventilation and arterial catheterization, while also caring for at least one additional patient. 

Interestingly, text messages were not significantly associated with errors.

The bottom line

The authors note that communication-related interruptions in PICUs cannot be fully eliminated. However, they write that “interventions to reduce the frequency and adverse consequences of interruptions should include consideration of time of day, nurse experience, nurse-to-patient ratio, and level of patient care required.”

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