Interruptions experienced by cardiovascular intensive care unit nurses: an observational study

J Crit Care. 2014 Oct;29(5):848-53. doi: 10.1016/j.jcrc.2014.05.007. Epub 2014 May 28.


Purpose: Intensive care unit (ICU) nurses get interrupted frequently. Although interruptions take cognitive resources from a primary task and may hinder performance, they may also convey critical information. Effective management of interruptions in ICUs requires the understanding of interruption characteristics, the context in which interruption happens, and interruption content.

Methods: An observational study was conducted in a cardiovascular ICU at a Canadian teaching hospital. Four observers (1 PhD and 3 undergraduate students) trained in human factors research observed 40 nurses, approximately 1 hour each, over a 3-week period. Data were recorded by the observers in real time, using touchscreen tablet PCs and special software designed for this purpose.

Results: Although approximately half of the interruptions (~51%) happened during high-severity tasks, more than half of these interruptions, which happened during high-severity tasks, conveyed either work- or patient-related information. Furthermore, the rate of interruptions with personal content was significantly higher during low-severity tasks compared with medium- and high-severity tasks.

Conclusions: Mitigation strategies other than blocking should also be explored. In addition, interrupters might have evaluated primary task severity before interrupting. Therefore, making task severity more transparent may help others modulate when and how they interrupt a nurse.

Keywords: Cardiovascular; ICU; Interruptions; Nursing; Task severity.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Canada
  • Critical Care Nursing*
  • Hospitals, Teaching
  • Humans
  • Intensive Care Units / organization & administration
  • Nursing Staff, Hospital / statistics & numerical data*
  • Task Performance and Analysis*
  • Work