Coping with interruptions in clinical nursing-A qualitative study.

AIMS AND OBJECTIVES: To gain knowledge on how nurses' cope with interruptions in clinical practice.

BACKGROUND: Interruptions may delay work routines and result in wasted time, disorganised planning and ineffective working procedures, affecting nurses' focus and overview in different ways. Research has identified a growing problem linking errors or adverse events with interruptions. It may affect patient safety if nurses are not paying attention to interruptions. Little is known about how nurses cope with interruptions DESIGN: The study was inspired by ethnographic fieldwork with a hermeneutical phenomenological approach.

METHODS: Observations were performed combined with semi-structured qualitative interviews.

RESULTS: Managing interruptions depend on level of competence, working environment, dialogue and matching of expectations, collegial roles and implicit rules. Working procedures impact on how nurses are exposed to unnecessary interruptions. The latter affects overview and the ability to put the foot down and decline being interrupted. Professional competencies for example prioritising, keeping focus and collaborating across disciplines are needed to cope with interruptions.

CONCLUSION: Culture work and matching of expectations are important to reflect on and discuss personal- and group behaviour caused by interruptions. We need to focus on the role of each nurse in the professional team, types of personality and unspoken rules. Professional competencies for example prioritising, keeping focus and cooperating across disciplines are needed to cope with interruptions.

RELEVANCE TO CLINICAL PRACTICE: Coping with interruptions is important for the nursing profession, quality of care and patient safety. Changing practice requires multidisciplinary cooperation accepting different agendas at personal, group and organisational levels. Nurses must understand the meaning and nature of different types of interruptions to develop coping strategies and maintain quality in care and patient safety in multidisciplinary teamwork.