Nurse Attentiveness: Focused, Sidetracked, Derailed or Misplaced? By: Andrea Platt, RN Education Consultant St.Vincent Indianapolis Hospital

Objectives Summarize factors which affect our ability to focus on information and tasks. Describe the potential impact attention issues have on patient safety. Discuss possible strategies for managing challenges to attentiveness.

Merriam-Webster Definition of ATTENTION! the act or state of applying the mind to something. a condition of readiness for such attention involving especially a selective narrowing or focusing of consciousness and receptivity.

Inattentional Blindness

What Captures Our Attention?

Processing Information

Conspicuity – Sensory & Cognitive Obviously it means it’s obvious.

Sensory

“Cocktail Party Effect” “blah, blah, blah, blah, Andrea, blah, blah, hehehehehehe..” “Cocktail Party Effect”

Mental Workload

Multitasking Exercise

Occurs when part of our attention is devoted to a secondary task Mental Workload Occurs when part of our attention is devoted to a secondary task

WHODUNNIT

Auditory Attention & Visual Inattentional Blindness Study by: Silvia Pizzighello & Paola Bressan

Ability to focus your attention Capacity Ability to focus your attention

Attention & Patient Safety Interruptions / Distractions

Definition of Interrupt Merriam-Webster To stop or hinder by breaking in. To break the uniformity or continuity of

Definition of Distract Merriam-Webster To turn aside To draw or direct (as one’s attention) to a different object or in different directions at the same time

“Going blank…” article Linda McGillis Hall et. al. “Through a range of studies there is sufficient evidence to suggest that a workplace where staff are constantly interrupted, or asked to switch tasks, is one where there is a greater propensity towards adverse events and corresponding diminished patient safety.”

An interruption driven profession

Sources Other nurses or health care staff Self Environment Patient Family member/visitors

Types Distractions Intrusions Discrepancies Breaks

Potential Causes Communications: questions and information Need for help Small talk Environmental Noise: Alarms, Pagers Patient needs Telephone Waiting for / searching for patient and/or supplies

Activity Interrupted Patient assessments or procedures Documentation Medication administration Communicating/consulting about a patient Less frequently: performing housekeeping or clerical work.

Outcomes - Potential Delay in treatment Loss of concentration or focus Positive Staff frustrations / ineffectiveness

Possible Strategies for Managing Attentiveness

Leader Strategies Interruption awareness Orientation – new hires Staff Interprofessional team Patients & Visitors Orientation – new hires Managing interruptions at critical times Documentation Medication Prep/Admin Procedures Patient Assessment

You now have my undivided attention Questions & Answers You now have my undivided attention

Nurse Attentiveness: Focused, Sidetracked, Derailed or Misplaced? By: Andrea Platt, RN Education Consultant St.Vincent Indianapolis Hospital