LAUSR

Aim A high level of reported prescribing errors were noted on the neonatal intensive care unit in 2018. In an attempt to decrease prescribing errors the use of noise-cancelling headphones whilst prescribing was introduced and evaluated. Methods A focus group amongst prescribers to ascertain reasons behind the high level of errors highlighted interruptions during prescribing as the main concern. This led to a discussion about the use of noise-cancelling headphones and the decision was made to trial their use. For one month prescribers wore headphones when prescribing. Nursing staff were encouraged to remind prescribers to wear the headphones and not to interrupt prescribers when the headphones were in use. The trial period was supported by a promotional campaign. Following the trial feedback from prescribers and nursing staff was obtained and the number of reported prescribing errors reviewed. Results Prescribing errors fell by 62%; from 16 in the month prior to 6 during the trial month. Online surveys amongst prescribers and nurses who participated in the trial showed congruity with the focus group; the leading factor, as cited by 83% of participants, was interruptions/distractions. During the trial 80% of prescribers stated they ‘usually’ or ‘always’ wore headphones when prescribing. For times they were not used, comfort and not thinking they were effective were the common reasons reported. When worn, 86% of prescribers agreed that interruptions were decreased. Concerns regarding prescribers ability to respond to emergencies while wearing headphones was not felt to be an issue by 93% of prescribers and 77% of nurses. Conclusion During the trial of noise-cancelling headphones use, prescribing errors significantly decreased. The use of headphones was seen as a positive intervention and the majority of staff reported fewer interruptions during prescribing with no impact on responding to emergencies. As a result, the use of noise-cancelling headphones when prescribing has continued in our unit.