Effects of mental workload on nurses' visual behaviors during infusion pump operation

Aim: According to a national report on incident analysis, the mental workload that exists during the i.v. medication administration process might affect nurses' visual behavior and, thus, influence the accuracy of the process. This study examined changes in the visual behavior of nurses who operated an infusion pump under the influence of time pressure and dual tasking. Methods: Ten nursing students, 13 experienced nurses, and nine inexperienced nurses, equipped with an eye tracker and instruments that measure the heart rate and breathing frequency, carried out an infusion pump operation in a simulated patient room under three mental workload conditions: without a mental workload, under time pressure, and while dual tasking. Results: Under the time pressure condition, the total visual fixation duration of the procedures was shortened. The experienced and inexperienced nurse groups could shorten the tasks in order of priority but the student group could reduce the tasks only inconsistently. Dual tasking had no influence on the total fixation duration of the procedures. However, the fixation location was influenced by the dual-tasking condition. This condition caused dispersed attention in the student and inexperienced-nurse groups, but not in the experienced-nurse group. Conclusion: Time pressure appears to cause nurses to shorten the duration of infusion pump operation and to reduce the quantity of checking. Dual tasking appears to have no influence on the total visual fixation duration but causes dispersed attention, reducing the quality of checking.