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AIMS AND OBJECTIVES To synthesise and summarise data gathered by direct observation of the characteristics of interruptions in the context of nursing medication administration (MA) in hospital settings. BACKGROUND Interruptions are prevalent during the MA process performed by nurses in hospital settings and have been found to be associated with an increase in frequency and severity of nursing MA errors. In addition, interruptions decrease task efficiency, leading to longer MA completion times. DESIGN Integrative review. METHODS The electronic databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycARTICLES and Google Scholar were searched using the terms "interruptions" AND "medication administration" AND "direct observation." Nine articles met the inclusion criteria. RESULTS Interruptions are likely to occur at least once during nursing MA processes in hospital settings. This finding applies to medication administered to one patient, termed a medication pass, and medication administered to multiple patients, termed a medication round. Interruptions are most commonly caused by another nurse or staff member or are self-initiated, and last approximately 1 min in length. CONCLUSIONS A raised awareness among staff of the most common sources of interruptions may encourage changes that lead to a decrease in the occurrence of interruptions. In addition, nurse leaders can apply an understanding of the common characteristics of interruptions to guide research, policies and educational methods aimed at interruption management strategies. RELEVANCE TO CLINICAL PRACTICE The findings from this review can be used to guide the identification and development of targeted interventions and strategies that would have the most substantial impact to reduce and manage interruptions during MA. Interruption management strategies have the potential to lead to a decrease in medication errors and an increase in task efficiency.