Qual Saf Health Care 19:1-6 doi:10.1136/qshc.2009.036871
  • Quality improvement report

The impact of a set of interventions to reduce interruptions and distractions to nurses during medication administration

  1. Bernard Silke
  1. St James's Hospital, Dublin, Ireland
  1. Correspondence to Ms Eileen Relihan, Medication Safety Office, Chief Executive Offices, St James's Hospital, James's Street, Dublin 8, Ireland; erelihan{at}
  • Accepted 18 January 2010
  • Published Online First 28 May 2010


Objective To assess the impact of a set of interventions in reducing the interruption/distraction rate during medication administration.

Design and participants Pre- and postintervention observational study of nurses undertaking medication rounds.

Setting Acute Medical Admissions Unit (AMAU) of a 1000-bed teaching hospital.

Intervention A set of measures previously proven successful in reducing interruptions (behaviour modification and staff education; checklists; visible symbols in the form of a red vest; and signage) were adapted and introduced onto the AMAU.

Main outcome measures Rate of interruptions and distractions pre- and postintervention overall and for each individual source of interruption.

Results There was a highly significant association (p<0.0001) between the overall interruption/distraction rate and the pre-/postintervention studies, with the rate of interruptions postintervention being 0.43 times that of the preintervention level. When individual sources of interruptions and distractions were compared pre- and postintervention, a significant difference (p<0.05) in the interruption/distraction rate was found for five of the 11 categories assessed.

Conclusions The data support a multifactorial approach to reducing the interruption/distraction rate on medication rounds. Suggestions for future research include: directly quantifying the impact of the interventions described in this study on the volume of medication administration errors; assessing the time lost as a result of interruptions and distractions during the medication round; and developing a standardised means of recording and analysing interruptions and distractions to allow meaningful comparison of the benefits of interventions across studies.


  • Competing interests The authors have no conflicts of interest other than that they are reporting outcomes from the organisation by which they are also employed.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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