Graduate School of Nursing Dissertations

Publication Date


Document Type

Dissertation, Doctoral


Graduate School of Nursing

Dissertation Committee Chair

Carol Bova


Cognitive resources, distraction, error, patient safety, situation awareness

Subject Categories

Health and Medical Administration | Health Services Administration | Nursing


Dissertations, UMMS; Patient Safety; Patient Care Management; Awareness; Cognition; Medical Errors


Purpose: The purpose of this study was to explore the experiences of distracted practice across the healthcare team.

Definition: Distracted practice is the diversion of a portion of available cognitive resources that may be needed to effectively perform/carry out the current activity.

Background: Distracted practice is the result of individuals interacting with the healthcare team, the environment and technology in the performance of their jobs. The resultant behaviors can lead to error and affect patient safety.

Methods: A qualitative descriptive (QD) approach was used that integrated observations with semi-structured interviews. The conceptual framework was based on the distracted driving model and a completed concept analysis.

Results: There were 22 observation sessions and 32 interviews (12 RNs, 11 MDs, and 9 Pharmacists) completed between December, 2014 and July 2015. Results suggested that distracted practice is based on the main theme of cognitive resources which varies by the subthemes of individual differences; environmental disruptions; team awareness; and “rush mode”/time pressure.

Conclusions and Implications: Distracted practice is an individual human experience that occurs when there are not enough cognitive resources available to effectively complete the task at hand. In that moment an individual shifts from thinking critically, being able to complete their current task without error, to not thinking critically and working in an automatic mode. This is when errors occur. Additional research is needed to evaluate intervention strategies to reduce and prevent distracted practice.


Material from this dissertation has been published in: (1) D'Esmond LK. Distracted Practice: A Concept Analysis. Nurs Forum. 2015 Nov 25. doi: 10.1111/nuf.12153. [Epub ahead of print] PubMed PMID: 26601791; and (2) D'Esmond LK. Distracted Practice and Patient Safety: The Healthcare Team Experience. Nurs Forum. 2017 Jul;52(3):149-164. doi: 10.1111/nuf.12173. Epub 2016 Jul 19. PubMed PMID: 27434026.

Rights and Permissions

© Copyright by Lynn K. D’Esmond 2016. All rights reserved.



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