Darlene Barkman winces a little when she thinks back to when her daughter, Lauren, was undergoing chemotherapy as an outpatient. "We got to know the nurses, and while that day’s nurse would be punching the doses into the med pump, I’d be talking to the nurse, asking about her weekend, things like that," she recalls.
Barkman now knows better than to distract nurses when they are doing the all-important job of setting a medical pump or otherwise ordering, collecting, preparing or administering medication. Barkman is a CHOP Family Consultant and a member of a team that initiated a patient safety program called Medication Safety Zone. The goal is to limit interruptions of nurses and physicians at any point along the chain of events involved in giving children their medication. Fewer interruptions mean fewer chances to get distracted and fewer medication errors.
The "no interruption" rule applies to family members who may be in their child’s room and also to any staff member who might encounter another clinician as he or she is in the process of ordering or administering medication. As part of a research study, CHOP nurses in Oncology counted interruptions as their peers went from the patient’s room to the medication room and back to the patient’s room.
After the Medication Safety Zones went into effect, there were 42 percent fewer interruptions. Zones were marked by a line of tape. They also set up safety zones for clinicians who use computer monitors to check or enter chemotherapy orders — a flag on the monitor meant "do not disturb" — and provided stop signs clinicians could place on their office doors while prescribing chemotherapy.
Success in Oncology and in the Pediatric Intensive Care Unit, which also ran a pilot, has led to Medication Safety Zones being designated on other inpatient units. If your child is in the Hospital, your nurse will explain how the Medication Safety Zones work. The nurse will still explain each medicine, review doses and frequency with you, and give you a chance to ask questions — even to call a safety time-out if you think the medicine is wrong.
If you see clinicians in one of the taped-off areas, please don’t distract them, unless it’s an emergency. If your nurse asks for a few interruption-free moments while she programs the medication pump or checks your child’s medications against the patient ID band and written orders, understand that she’s not being rude — she’s being safe.