None of this is conducive to the completion of nursing tasks that require concentration and thoughtfulness. In particular, nurses are easy prey for distractions when they stand in front of their medication carts, and this increases the risk something will go wrong.
Sculli and his unit adopted a "do not distract" principle by designating one nurse a MedSafe nurse who was responsible for all medication administration on the unit. During peak medication administration times, the nurse wore a brightly colored vest labeled "do not disturb" to ensure others did not interrupt him or her during this period of deep concentration.
Sculli also worked on changing the way nurses on his team communicate—and to convince them that they were, in fact, a team. Information exchanges between RNs and nursing assistants—who often have trouble communicating—was improved through adopting briefings. Sculli and the staff developed a checklist with which RNs covered patient information that nursing assistants needed to know about their patients for that shift. The briefings were short and to the point to ensure RNs and assistants were on the same page for the upcoming shift.
A big emphasis for Sculli now as he teaches CRM to frontline nurses is the importance of communicating patient information in a manner that is specific, direct, and concise.