Department of Urology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
Surg Endosc. 2011 Feb;25(2):437-43. doi: 10.1007/s00464-010-1186-8. Epub 2010 Aug 24.
Professionals working in the operating room (OR) are subject to various distractions that can be detrimental to their task performance and the quality of their work. This study aimed to quantify the frequency, nature, and effect on performance of (potentially) distracting events occurring during endourological procedures and additionally explored urologists' and residents' perspectives on experienced ill effects due to distracting factors.
First, observational data were collected prospectively during endourological procedures in one OR of a teaching hospital. A seven-point ordinal scale was used to measure the level of observed interference with the main task of the surgical team. Second, semistructured interviews were conducted with eight urologists and seven urology residents in two hospitals to obtain their perspectives on the impact of distracting factors.
Seventy-eight procedures were observed. A median of 20 distracting events occurred per procedure, which corresponds to an overall rate of one distracting event every 1.8 min. Equipment problems and procedure-related and medically irrelevant communication were the most frequently observed causes of interruptions and identified as the most distracting factors in the interviews. Occurrence of distracting factors in difficult situations requiring high levels of concentration was perceived by all interviewees as disturbing and negatively impacting performance. The majority of interviewees (13/15) thought distracting factors impacted more strongly on residents' compared to urologists' performance due to their different levels of experience.
Distracting events occur frequently in the OR. Equipment problems and communication, the latter both procedure-related and medically irrelevant, have the largest impact on the sterile team and regularly interrupt procedures. Distracting stimuli can influence performance negatively and should therefore be minimized. Further research is required to determine the direct effect of distraction on patient safety.
手术室（OR）中的专业人员会受到各种干扰，这可能会对他们的任务表现和工作质量产生不利影响。本研究旨在量化发生在腔内泌尿外科手术过程中潜在干扰事件的频率、性质和对性能的影响，并探讨泌尿科医生和住院医师对因干扰因素而产生的不良影响的看法。
首先，在一家教学医院的一个 OR 中，前瞻性地收集腔内泌尿外科手术的观察数据。使用七点有序量表来衡量观察到的对手术团队主要任务的干扰程度。其次，在两家医院对 8 名泌尿科医生和 7 名泌尿科住院医师进行半结构化访谈，以了解他们对干扰因素影响的看法。
观察了 78 例手术。每例手术平均发生 20 次干扰事件，相当于每 1.8 分钟发生一次干扰事件。设备问题、与手术相关和与医疗无关的沟通是最常观察到的中断原因，并在访谈中被确定为最具干扰性的因素。所有受访者都认为，在需要高度集中注意力的困难情况下发生干扰因素会令人不安，并对表现产生负面影响。大多数受访者（13/15）认为，由于经验水平不同，干扰因素对住院医师的表现影响比对泌尿科医生的表现影响更大。
干扰事件在 OR 中频繁发生。设备问题和沟通，包括与手术相关和与医疗无关的沟通，对无菌团队的影响最大，并经常中断手术。干扰刺激会对性能产生负面影响，因此应尽量减少。需要进一步研究以确定分心对患者安全的直接影响。
