Abstract

Background: Medication administration has inherent risks, with errors having enormous impact on the quality and efficiency of patient
care, particularly in relation to experience, outcomes and safety. Nurses are pivotal to the medication administration process and therefore must
demonstrate safe and reliable practice. However, interruptions can lead to mistakes and omissions.
Aim: To critique and synthesize the existing literature relating to the impact that interruptions have during medication administration within
the paediatric critical care (PCC) setting.
Search strategy: Key terms identified from background literature were used to search three electronic databases (Medline, CINHAL and
BNI). Selected sources were critically appraised using the Critical Appraisal Skills Programme (CASP) tool.
Findings: There is confusion within the literature concerning the definition of interruption. Moreover, an assumption that all interruptions have
a negative impact on patient safety exists. The literature identifies the multi-dimensional nature of interruptions and their impact on medication
administration and patient safety. The cumulative effect of interruptions depends on what type of task is being completed, when it occurs, what
the interruption is and which method of handling is utilized. A conceptual schema has been developed in order to explicate the themes and
concepts that emerged.
Conclusions: This review summarizes debates within the international arena concerning the impact of interruptions on medication
administration. However, conclusions drawn appear applicable in relation to practice, education and future research to other critical care settings.
Relevance to clinical practice: Findings show that no single strategy is likely to improve the negative effect of interruptions without
focus on patient safety. Practice education to improve team building interactions is required that equips nurses with the skills in managing
interruptions and delegating high priority secondary tasks.