Nurses’ experience of work interruption during the medication administration: A qualitative study
Abstract
Background & Aim: Work interruptions during medication administration increase the risk of errors, compromising patient safety and underscoring the need to examine the complex challenges nurses face in ensuring medication safety. The purpose of this study was to examine nurses’ experiences with interruptions during medication administration, their sources, impacts, and how nurses responded to and managed these situations.
Methods & Materials: A qualitative design was used, and in-depth interviews were conducted with sixteen nurses from tertiary hospitals in Korea using a semi-structured interview guide. Data were analyzed using directed content analysis based on an initial coding scheme.
Results: Three main themes and 10 sub-themes emerged from the analysis. Nurses reported interruptions from various sources, including healthcare colleagues, external departments, patients and caregivers, and environmental factors. These interruptions resulted in workflow fragmentation, elevated medication error risk, and significant emotional burden. In response, nurses employed various individual coping mechanisms while also identifying the need for organizational support.
Conclusion: Interruptions during medication administration stem from multiple sources and impose significant risks for errors, workflow disruption, and emotional burden on nurses. This study suggests that context-sensitive strategies, such as standardizing communication, delegating non-urgent requests, and enhancing education for healthcare providers, patients, and caregivers, are essential to reduce avoidable interruptions while supporting safe medication practices.
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8. Puranik H, Koopman J, Vough HC. Pardon the interruption: An integrative review and future research agenda for research on work interruptions. Journal of Management. 2020 Jul;46(6):806-42.
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13. Wang Q, Ding X, Zhu M, Chen H, Yang Y, Wang Y, Gan Z, Chung Y, Li Z. Experiences of clinical nurses with medication interruption: A systematic review and qualitative meta‐synthesis. Worldviews on Evidence‐Based Nursing. 2024 Dec;21(6):598-610.
14. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005 Nov;15(9):1277-88.
15. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007 Dec 1;19(6):349-57.
16. Biron AD, Lavoie‐Tremblay M, Loiselle CG. Characteristics of work interruptions during medication administration. Journal of Nursing Scholarship. 2009 Dec;41(4):330-6.
17. Johnson M, Levett-Jones T, Langdon R, Weidemann G, Manias E, Everett B. A qualitative study of nurses' perceptions of a behavioural strategies e-learning program to reduce interruptions during medication administration. Nurse Education Today. 2018 Oct 1;69:41-7.
18. Westbrook JI, Li L, Hooper TD, Raban MZ, Middleton S, Lehnbom EC. Effectiveness of a ‘Do not interrupt’bundled intervention to reduce interruptions during medication administration: A cluster randomised controlled feasibility study. BMJ Quality & Safety. 2017 Sep 1;26(9):734-42.
19. Lincoln Y, Guba E. Naturalistic Inquiry. Beverly Hills, CA: SAGE Publications; 1985.
20. Saifan, A. R., Dimitri, A., Al-Yateem, N., Shajrawi, A., Hamdan, K., Al-Habeis, O. M.et al. Medication errors occurrence and reporting: A qualitative study of the Jordanian nurses' experiences. Nursing Practice Today. 2024;11(2): 141-9.
21. Nguyen EE, Connolly PM, Wong V. Medication safety initiative in reducing medication errors. Journal of Nursing Care Quality. 2010 Jul 1;25(3):224-30.
22. Weigl M, Beck J, Wehler M, Schneider A. Workflow interruptions and stress at work: a mixed-methods study among physicians and nurses of a multidisciplinary emergency department. BMJ Open. 2017 Dec 1;7(12):e019074.
23. Schroers G, Ross JG, Moriarty H. Undergraduate nursing students and management of interruptions: Preparation of students for future workplace realities. Nursing Education Perspectives. 2021 Nov 1;42(6):350-7.
24. Johnson M, Weidemann G, Adams R, Manias E, Levett-Jones T, Aguilar V, Everett B. Predictability of interruptions during medication administration with related behavioral management strategies. Journal of Nursing Care Quality. 2018 Apr 1;33(2):E1-9.
25. Buchini S, Quattrin R. Avoidable interruptions during drug administration in an intensive rehabilitation ward: improvement project. Journal of Nursing Management. 2012 Apr;20(3):326-34.
26. Berdot S, Vilfaillot A, Bezie Y, Perrin G, Berge M, Corny J, Thi TT, Depoisson M, Guihaire C, Valin N, Decelle C. Effectiveness of a ‘do not interrupt’ vest intervention to reduce medication errors during medication administration: A multicenter cluster randomized controlled trial. BMC Nursing. 2021 Aug 24;20(1):153.
27. Palese A, Ferro M, Pascolo M, Dante A, Vecchiato S. “I Am Administering Medication—Please Do Not Interrupt Me”: Red Tabards Preventing Interruptions as Perceived by Surgical Patients. Journal of Patient Safety. 2019 Mar 1;15(1):30-6.
28. Henneman EA, Marquard JL, Nicholas C, Martinez V, DeSotto K, Scott SS, Soares WE, Henneman PL. The Stay SAFE strategy for managing interruptions reduces distraction time in the simulated clinical setting. Critical Care Nursing Quarterly. 2018 Apr 1;41(2):215-23.
29. Yoon YS, Lee W, Kang S, Kim IS, Jang SG. Working Experience of Managers Who Are Responsible for Promoting and Monitoring Patient Safety in South Korea: Focusing on Small-and Medium-Sized Hospitals. Journal of Patient Safety. 2022 Jun 1;18(4):365-9.
30. Blok AC, Anderson E, Swamy L, Mohr DC. Comparing nurse leader and manager perceptions of and strategies for nurse engagement using a positive deviance approach: A qualitative analysis. Journal of Nursing Management. 2021 Sep;29(6):1476-85.
2. Musharyanti L, Claramita M, Haryanti F, Dwiprahasto I. Why do nursing students make medication errors? A qualitative study in Indonesia. Journal of Taibah University Medical Sciences. 2019 Jun 1;14(3):282-8.
3. Yu EJ, Lee EN, Kim JM, Jun HJ. Concept analysis of the work interruption by nurses. Journal of Korean Academy of Nursing Administration. 2019 Sep 30;25(4):272-81.
4. Reed CC, Minnick AF, Dietrich MS. Nurses’ responses to interruptions during medication tasks: A time and motion study. International Journal of Nursing Studies. 2018 Jun 1;82:113-20.
5. Forsyth KL, Hawthorne HJ, El-Sherif N, Varghese RS, Ernste VK, Koenig J, Blocker RC. Interruptions experienced by emergency nurses: implications for subjective and objective measures of workload. Journal of Emergency Nursing. 2018 Nov 1;44(6):614-23.
6. Westbrook JI, Woods A, Rob MI, Dunsmuir WT, Day RO. Association of interruptions with an increased risk and severity of medication administration errors. Archives of Internal Medicine. 2010 Apr 26;170(8):683-90.
7. Schroers G. Characteristics of interruptions during medication administration: An integrative review of direct observational studies. Journal of Clinical Nursing. 2018 Oct;27(19-20):3462-71.
8. Puranik H, Koopman J, Vough HC. Pardon the interruption: An integrative review and future research agenda for research on work interruptions. Journal of Management. 2020 Jul;46(6):806-42.
9. Dall'Oglio I, Fiori M, Di Ciommo V, Tiozzo E, Mascolo R, Bianchi N, Degli Atti ML, Ferracci A, Gawronski O, Pomponi M, Raponi M. Effectiveness of an improvement programme to prevent interruptions during medication administration in a paediatric hospital: A preintervention–postintervention study. BMJ Open. 2017 Jan 1;7(1):e013285.
10. Danesh V, Sasangohar F, Kallberg AS, Kean EB, Brixey JJ, Johnson KD. Systematic review of interruptions in the emergency department work environment. International Emergency Nursing. 2022 Jul 1;63:101175.
11. Rivera-Rodriguez AJ, Karsh BT. Interruptions and distractions in healthcare: Review and Reappraisal. BMJ Quality & Safety. 2010 Aug 1;19(4):304-12.
12. Glanville D, Hutchinson A, Khaw D. Handheld computer devices to support clinical decision-making in acute nursing practice: systematic scoping review. Journal of Medical Internet Research. 2023 Feb 13;25:e39987.
13. Wang Q, Ding X, Zhu M, Chen H, Yang Y, Wang Y, Gan Z, Chung Y, Li Z. Experiences of clinical nurses with medication interruption: A systematic review and qualitative meta‐synthesis. Worldviews on Evidence‐Based Nursing. 2024 Dec;21(6):598-610.
14. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005 Nov;15(9):1277-88.
15. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007 Dec 1;19(6):349-57.
16. Biron AD, Lavoie‐Tremblay M, Loiselle CG. Characteristics of work interruptions during medication administration. Journal of Nursing Scholarship. 2009 Dec;41(4):330-6.
17. Johnson M, Levett-Jones T, Langdon R, Weidemann G, Manias E, Everett B. A qualitative study of nurses' perceptions of a behavioural strategies e-learning program to reduce interruptions during medication administration. Nurse Education Today. 2018 Oct 1;69:41-7.
18. Westbrook JI, Li L, Hooper TD, Raban MZ, Middleton S, Lehnbom EC. Effectiveness of a ‘Do not interrupt’bundled intervention to reduce interruptions during medication administration: A cluster randomised controlled feasibility study. BMJ Quality & Safety. 2017 Sep 1;26(9):734-42.
19. Lincoln Y, Guba E. Naturalistic Inquiry. Beverly Hills, CA: SAGE Publications; 1985.
20. Saifan, A. R., Dimitri, A., Al-Yateem, N., Shajrawi, A., Hamdan, K., Al-Habeis, O. M.et al. Medication errors occurrence and reporting: A qualitative study of the Jordanian nurses' experiences. Nursing Practice Today. 2024;11(2): 141-9.
21. Nguyen EE, Connolly PM, Wong V. Medication safety initiative in reducing medication errors. Journal of Nursing Care Quality. 2010 Jul 1;25(3):224-30.
22. Weigl M, Beck J, Wehler M, Schneider A. Workflow interruptions and stress at work: a mixed-methods study among physicians and nurses of a multidisciplinary emergency department. BMJ Open. 2017 Dec 1;7(12):e019074.
23. Schroers G, Ross JG, Moriarty H. Undergraduate nursing students and management of interruptions: Preparation of students for future workplace realities. Nursing Education Perspectives. 2021 Nov 1;42(6):350-7.
24. Johnson M, Weidemann G, Adams R, Manias E, Levett-Jones T, Aguilar V, Everett B. Predictability of interruptions during medication administration with related behavioral management strategies. Journal of Nursing Care Quality. 2018 Apr 1;33(2):E1-9.
25. Buchini S, Quattrin R. Avoidable interruptions during drug administration in an intensive rehabilitation ward: improvement project. Journal of Nursing Management. 2012 Apr;20(3):326-34.
26. Berdot S, Vilfaillot A, Bezie Y, Perrin G, Berge M, Corny J, Thi TT, Depoisson M, Guihaire C, Valin N, Decelle C. Effectiveness of a ‘do not interrupt’ vest intervention to reduce medication errors during medication administration: A multicenter cluster randomized controlled trial. BMC Nursing. 2021 Aug 24;20(1):153.
27. Palese A, Ferro M, Pascolo M, Dante A, Vecchiato S. “I Am Administering Medication—Please Do Not Interrupt Me”: Red Tabards Preventing Interruptions as Perceived by Surgical Patients. Journal of Patient Safety. 2019 Mar 1;15(1):30-6.
28. Henneman EA, Marquard JL, Nicholas C, Martinez V, DeSotto K, Scott SS, Soares WE, Henneman PL. The Stay SAFE strategy for managing interruptions reduces distraction time in the simulated clinical setting. Critical Care Nursing Quarterly. 2018 Apr 1;41(2):215-23.
29. Yoon YS, Lee W, Kang S, Kim IS, Jang SG. Working Experience of Managers Who Are Responsible for Promoting and Monitoring Patient Safety in South Korea: Focusing on Small-and Medium-Sized Hospitals. Journal of Patient Safety. 2022 Jun 1;18(4):365-9.
30. Blok AC, Anderson E, Swamy L, Mohr DC. Comparing nurse leader and manager perceptions of and strategies for nurse engagement using a positive deviance approach: A qualitative analysis. Journal of Nursing Management. 2021 Sep;29(6):1476-85.
| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| work interruption qualitative research patient safety nurses medication errors | ||
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How to Cite
1.
Lee W, Jang SG. Nurses’ experience of work interruption during the medication administration: A qualitative study. Nurs. pract. today. 2025;:X-X.
