Characteristics of work interruptions during medication administration

J Nurs Scholarsh. 2009;41(4):330-6. doi: 10.1111/j.1547-5069.2009.01300.x.


Objective: To document characteristics of nurses' work interruptions (WIs) during medication administration.

Design: A descriptive observational study design was used along with a sample of 102 medication administration rounds. Data were collected on a single medical unit using a unit dose distribution system during fall 2007.

Method: Data collection on WIs relied on direct structured observation. The following WI characteristics were recorded: source, secondary task, location, management strategies, and duration.

Results: 374 WIs were observed over 59 hours 2 minutes of medication administration time (6.3 WI/hr). During the preparation phase, nurse colleagues (n= 36; 29.3%) followed by system failures such as missing medication or equipment (n= 28; 22.8%) were the most frequent source of WIs. Nurses were interrupted during the preparation phase mostly to solve system failures (n= 33; 26.8%) or for care coordination (n= 30; 24.4%). During the administration phase, the most frequent sources of WIs were self-initiation (n= 41; 16.9%) and patients (n= 39; 16.0%). The most frequent secondary task undertaken during the administration phase was direct patient care (n= 105; 43.9%). WIs lasted 1 min 32 s on average, and were mostly handled immediately (n= 357; 98.3%).

Conclusions: The process of medication administration is not protected against WIs, which poses significant risks.

Clinical relevance: Interventions to reduce WIs during the medication administration process should target nurses and system failures to maximize medication administration safety.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Communication
  • Continuity of Patient Care
  • Drug Therapy / methods
  • Drug Therapy / nursing*
  • Drug Therapy / statistics & numerical data
  • Efficiency, Organizational
  • Hospitals, University
  • Humans
  • Interprofessional Relations
  • Medication Errors / nursing
  • Medication Errors / prevention & control
  • Medication Errors / statistics & numerical data
  • Medication Systems, Hospital / organization & administration*
  • Nurse's Role*
  • Nursing Administration Research
  • Nursing Evaluation Research
  • Nursing Staff, Hospital / organization & administration*
  • Nursing Staff, Hospital / psychology
  • Quebec
  • Risk Assessment
  • Safety Management
  • Systems Analysis
  • Time and Motion Studies
  • Workload* / statistics & numerical data