School of Medicine, University of Otago, Dunedin, New Zealand.
Department of Population Health, University of Otago, Christchurch, New Zealand.
ANZ J Surg. 2021 May;91(5):841-846. doi: 10.1111/ans.16799. Epub 2021 Apr 29.
Operating theatres (OTs) are complex environments where team members complete difficult tasks under stress. Distractions in these environments can lead to errors that compromise patient safety. A range of potential distractions exist in OTs and previous research suggests they are common. This study assesses the nature, frequency and impact of distracting events in the OT at a tertiary New Zealand hospital.
Prospective observational study of the frequency, type and impact of OT distractions during a 3-month period. Two observational methods - the frequency of door openings and a validated tool - were used to categorize OT distractions for a range of acute and elective, paediatric and adult surgical procedures according to their cause and effect.
There were 57 procedures (2037 intraoperative minutes) observed. During this time, 721 door openings and 1152 other distracting events were recorded. On average, either a door opening or other distracting event was recorded 56 times per hour of intraoperative time. The frequency of distractions did not vary in relation to acute versus elective or paediatric versus adult procedures but were more common in the morning. Communication unrelated to the case was the most common distracting event: these and equipment issues had the greatest effect on the entire surgical team, usually by causing some interruption to operative flow.
Distractions in OTs were common, occurring nearly every minute. Most were trivial, but some had the potential to disrupt the operative procedure and result in patient harm. Reducing distractions in surgery could reduce patient harm and improve resource use.
手术室（OT）是团队成员在压力下完成困难任务的复杂环境。这些环境中的分心会导致危及患者安全的错误。OT 中存在多种潜在的分心因素，先前的研究表明这些分心因素很常见。本研究评估了新西兰一家三级医院 OT 中的分心事件的性质、频率和影响。
对 3 个月期间 OT 中分心频率、类型和影响的前瞻性观察研究。使用两种观察方法——开门频率和经过验证的工具——根据其原因和影响，对一系列急性和择期、儿科和成人手术程序的 OT 分心进行分类。
观察了 57 个程序（2037 个手术室内分钟）。在此期间，记录了 721 次开门和 1152 次其他分心事件。平均而言，每小时手术室内时间记录 56 次开门或其他分心事件。分心的频率与急性与择期或儿科与成人程序无关，但在早上更为常见。与病例无关的沟通是最常见的分心事件：这些事件和设备问题对整个手术团队的影响最大，通常会导致手术流程中断。
OT 中的分心很常见，几乎每分钟都会发生。大多数是微不足道的，但有些可能会扰乱手术程序并导致患者伤害。减少手术中的分心可以减少患者伤害并提高资源利用效率。
