Quantifying the relationship between physical environmental variables and interruption events during the medication process: An observational study

Interruptions during medication administration threaten patient safety in ICUs, yet their relationship to physical environmental features remains poorly understood. This observational study examined interruptions and recorded travel paths across three ICUs by shadowing 18 nurses during 100 medication rounds (29.25 h). Data were initially analyzed using descriptive statistics, path visualization, and heatmaps. Multiple linear regression was applied to examine relationships between layout variables and interruption number and duration. A total of 1,115 interruptions were recorded, primarily self-initiated (21.97%) and nurse-to-nurse interactions (18.30%). Travel distance strongly predicted interruptions, with each 100-foot increase causing a 26.8% increase. Medium and large units had 45% and 43% fewer interruptions than small units. Noon rounds had 31.6% fewer interruptions than afternoon rounds. Interruptions lasted longer at nurse stations (31.28-54.50s) and corridors (33.81-51.56s) than in patient rooms (26.48-43.57s). Results indicate that travel distance and unit size significantly impact interruption patterns, suggesting evidence-based design strategies can optimize ICU environments and improve medication administration safety.