Univ Rennes, INSERM, LTSI - UMR 1099, 35000 Rennes, France; Department of Neurosurgery, Pontchaillou University Hospital, 2 Rue Henri Le Guilloux, 35033 Rennes Cedex 9, France.
Univ Rennes, LP3C (Laboratoire de Psychologie : Cognition, Comportement, Communication) - EA 1285, 35000 Rennes, France.
Neurochirurgie. 2020 Aug;66(4):203-211. doi: 10.1016/j.neuchi.2020.02.003. Epub 2020 May 13.
Neurosurgical teams are exposed to various stressors: complexity of surgical procedures, environment, time pressure and interruptions contribute to increasing the perceived workload.
This study aimed to evaluate the impact of interruptions and surgical complexity on neurosurgical team workload.
A prospective observational study was conducted on thirty surgical procedures of graduated complexity recorded in our Department of Neurosurgery. A scale was created and used by neurosurgeons to evaluate the perceived complexity of the surgical procedure. Interruptions and severity of interruptions were noted. The workloads of the neurosurgeon, surgical assistant, scrub nurse and circulating nurse were measured on the Surgery Task Load Index (SURG-TLX) at the end of the procedure.
A mean 24.6 interruptions per hour were recorded. The mean interference level of the interruptions was 3.5/7. Mean surgical complexity was 4.3/10. Mean sterile team workload was 43.4/100. The multiple linear regression model showed that sterile team workload increased with surgical complexity (β=6.692, P=.0002) but decreased in spite of increases in the number of interruptions per hour (β=-0.855, P=.027). Neurosurgeon and surgical assistant workload increased with surgical complexity (β=11.53, P<0.0001 and β=7.42, P=0.0007, respectively). Scrub nurse workload decreased in spite of increases in the number of interruptions per hour (β=-1.11, P=.026).
Our study suggests positive effects of some interruptions during elective neurosurgical procedures with strong team familiarity.
神经外科团队面临着各种压力源：手术过程的复杂性、环境、时间压力和中断都会导致工作负荷增加。
本研究旨在评估中断和手术复杂性对神经外科团队工作负荷的影响。
对我院神经外科记录的 30 例不同难度等级的手术进行前瞻性观察研究。神经外科医生创建了一个量表来评估手术的复杂程度，并记录中断事件及其严重程度。手术结束后，使用手术任务负荷指数（SURG-TLX）对神经外科医生、手术助手、器械护士和巡回护士的工作负荷进行评估。
平均每小时记录 24.6 次中断。中断的平均干扰水平为 3.5/7。平均手术难度为 4.3/10。无菌团队的平均工作量为 43.4/100。多元线性回归模型显示，无菌团队的工作量随手术难度的增加而增加（β=6.692，P=.0002），但尽管每小时中断次数增加，工作量仍有所减少（β=-0.855，P=.027）。神经外科医生和手术助手的工作量随手术难度的增加而增加（β=11.53，P<0.0001 和β=7.42，P=0.0007）。尽管每小时中断次数增加，器械护士的工作量仍有所减少（β=-1.11，P=.026）。
我们的研究表明，在具有强烈团队熟悉度的择期神经外科手术中，某些中断具有积极影响。
