Interruptions during nurses' drug rounds in surgical wards: observational study ALVISA PALESE 1 , ARIANNA SARTOR BNS, RN 2 , GIULIANA COSTAPERARIA RN 3 and VITTORIO BRESADOLA 4 1 Associate Professor, School of Nursing, University of Udine, 2 Staff Nurse, School of Nursing, University of Udine, 3 Chief of Nurses, Surgical Department, University of Udine and 4 Associate Professor, Surgical Department, University of Udine, Udine, Italy Introduction Management of drug therapy is an integral part of the clinical role of nurses. The correct administration of drugs to patients is the direct responsibility of the nurse. Many errors are caused by imperfections in the (work- ing) system, in the assignment of work, in the training and understanding of staff and in the working conditions (Leape 1997, Armitage 2005, Hughes and Ortiz 2005). In a recent review of literature, OÕShea (1999) high- lighted factors that increase nursesÕ errors during the administration of drugs. Some of these are as a result of the nursesÕ scarce knowledge of mathematics and phar- macology and others are because of inexperience, shift work (for example, the difficulty in maintaining high concentration levels on night shift or working overtime) and the shortage of personnel, which creates an excessive workload. Other errors are caused by imperfections in Correspondence Alvisa Palese School of Nursing Udine University Viale Ungheria 18 33100 Udine Italy E-mail: alvisa.palese@uniud.it PALESE A., SARTOR A., COSTAPERARIA G. & BRESADOLA V. (2009) Journal of Nursing Management 17, 185–192 Interruptions during nurses' drug rounds in surgical wards: observational study Aims The purpose of the study was to examine the frequency and perceived risk of interruptions to nurses during drug rounds in seven Italian surgical wards. Background Management of drug therapy is an integral part of the clinical role of nurses. Many errors are caused by interruptions to which the nurse is subjected during the drug rounds. However, the frequency of interruptions to nurses during drug rounds has not yet been documented. Materials and methods An observational study design was developed: (1) 56 ran- domized drug rounds, eight for each ward included, were observed and (2) 28 convenience samples of observed nurses were interviewed. Results The administration of a total of 945 medications was observed, an average of 2.2 per patient being treated: 298 interruptions were observed (one for every 3.2 drugs given). Ten different categories of interruption emerged. The highest risk of error as a result of interruption perceived by these nurses was related to the management of telephone calls. Implications for nursing management Many of the interruptions as a result of the organization of work could be avoided: one organizational priority should be to create a calm atmosphere for administering drugs. Ways to develop a calm atmosphere are discussed. Keywords: avoidability, drug round, errors in drug administration, interruptions, pa- tient safety Accepted for publication: 12 October 2007 Journal of Nursing Management 2009, 17, 185–192 DOI: 10.1111/j.1365-2934.2007.00835.x ª 2008 Blackwell Publishing Ltd 185