Department of Surgery, Division of Bariatric & Minimally Invasive Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Department of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Surg Endosc. 2023 Mar;37(3):2316-2325. doi: 10.1007/s00464-022-09553-8. Epub 2022 Sep 7.
Distractions during surgical procedures are associated with team inefficiency and medical error. Little is published about the healthcare provider's perception of distraction and its adverse impact in the operating room. We aim to explore the perception of the operating room team on multiple distractions during surgical procedures.
A 26-question survey was administered to surgeons, anesthesia team members, nurses, and scrub technicians at our institution. Respondents were asked to identify and rank multiple distractions and indicate how each distraction might affect the flow of surgery.
There was 160 responders for a response rate of 19.18% (160/834), of which 71 (44.1%) male and 82 (50.9%) female, 48 (29.8%) surgeons, 59 (36.6%) anesthesiologists, Certified Registered Nurse Anesthetists (CRNA), and 53 (32.9%) OR nurses and scrub technicians. Responders were classified into a junior group (< 10 years of experience) and a senior group (≥ 10 years). Auditory distraction followed by equipment were the most distracting factors in the operating room. All potential auditory distractions in this survey were associated with higher percentage of certain level of negative impact on the flow of surgery except for music. The top 5 distractors belonged to equipment and environment categories. Phone calls/ pagers/ beepers and case relevant communications were consistently among the top 5 most common distractors. Case relevant communications, music, teaching, and consultation were the top 4 most perceived positive impact on the flow of surgery. Distractors with higher levels of "bothersome" rating appeared to associate with a higher level of perceived negative impact on the flow of surgery. Vision was the least distracting factor and appeared to cause minimal positive impact on the flow of surgery.
To our knowledge, this is the first survey studying perception of surgery, anesthesia, and OR staff on various distractions in the operating room. Fewer unnecessary distractions might improve the flow of surgery, improve OR teamwork, and potentially improve patient outcomes.
手术过程中的分心会导致团队效率低下和医疗失误。关于医疗保健提供者对分心的看法及其在手术室中的不良影响，发表的内容很少。我们旨在探讨手术室团队对手术过程中多种分心因素的看法。
我们向医院的外科医生、麻醉团队成员、护士和手术室技术员发放了一份包含 26 个问题的调查问卷。受访者被要求识别和对多项分心因素进行排名，并指出每项分心因素如何影响手术流程。
共有 160 名受访者做出了回应，回应率为 19.18%（160/834），其中 71 名男性（44.1%）和 82 名女性（50.9%），48 名外科医生（29.8%）、59 名麻醉师、注册护士麻醉师（CRNA）（36.6%）和 53 名手术室护士和手术室技术员（32.9%）。受访者被分为初级组（<10 年经验）和高级组（≥10 年经验）。在手术室中，听觉干扰其次是设备干扰，是最具干扰性的因素。本调查中的所有潜在听觉干扰因素都与手术流程受到更高程度负面影响的百分比相关，除了音乐。排名前五的干扰因素属于设备和环境类别。电话/寻呼机/蜂鸣器和与病例相关的通讯一直是排名前五的最常见干扰因素。与病例相关的通讯、音乐、教学和咨询是对手术流程最具感知积极影响的前四项因素。“令人烦恼”程度评分较高的干扰因素似乎与对手术流程的感知负面影响程度较高相关。视觉是最不具干扰性的因素，对手术流程的积极影响最小。
据我们所知，这是首次调查手术、麻醉和手术室工作人员对手术室中各种干扰因素的看法。减少不必要的干扰因素可能会改善手术流程、提高手术室团队合作，并有可能改善患者的治疗效果。
