'Not interrupted enough to be aware': A qualitative exploration of Paediatric Critical Care nurses’ decision-making when interrupted during medication administration

  • Rachel A. Bower

    Student thesis: Master's ThesisMaster of Science by Research


    Globally, the prevention of medication errors is a priority, due to the risk of harm to patients and associated costs (Frontier Economics, 2014). Interruptions are frequently cited as a contributory factor in errors due to their impact on cognitive processes (Laustsen and Brahe, 2015). In Paediatric Critical Care (PCC), medication administration is challenging due to the complexity of medicines, variable weight ranges and instability of patient condition (Dickinson et al, 2012). Furthermore,
    interruptions have been documented to occur frequently (Bower, 2015) and nurses are noted to have a fundamental role within the medication process.

    A qualitative exploratory study was conducted with the aim of critically exploring and understanding PCC nurse decision making when interrupted during medication administration. Data was collected sequentially using non-participant observation (n=10) and semi-structured interviews (n=10). Observations of medication
    administration episodes informed interview schedules. Data was analysed using Framework Analysis (Gale et al, 2013) including a critical realism lens.

    Analysis resulted in four overarching themes emerging from the data. (1) Guiding the medication process, (2) Concentration, focus and awareness, (3) Influences on interruptions and (4) Impact and recovery.

    Decision making is influenced by interruption awareness, fluctuating levels of concentration and responding to critically ill children and their family’s needs. Future development of interventions to reduce interruptions need to comprehend these
    influencing factors
    Date of Award2016
    Original languageEnglish
    Awarding Institution
    • Coventry University

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