在手术室喧嚣中创造清晰：对与噪声相关的有效沟通障碍和促进因素的混合方法分析
Creating Clarity Amid the Operating Room Clamor: A Mixed Methods Analysis of Noise-Related Barriers and Facilitators to Effective Communication.
作者信息
Hughes Sarah E, Manojlovich Milisa, Jacobson Clare E, McCaslin Devin L, McKee Michael M, Jain Dhruv, Bolze Andrew S, Hsu Isabel J, Stegink Candice, Reddy Rishindra M, Sheetz Kyle H, Brenner Michael J
机构信息
Medical School, University of Michigan-Ann Arbor.
School of Nursing, University of Michigan-Ann Arbor.
出版信息
ORL Head Neck Nurs. 2025 Spring;43(2):15-25.
BACKGROUND
The operating room is one of the noisiest healthcare environments, creating critical challenges for patient safety, team efficiency, and surgical outcomes. Operating room nurses, essential for patient care and team coordination, face unique risks from noise exposure and impaired communication, yet their challenges remain underexplored.
OBJECTIVE
To assess hearing challenges and communication barriers in operating room teams from nurses' perspectives, with implications for patient safety and interventions.
DESIGN
Cross-sectional survey.
METHODS
An electronic survey was distributed to operating room personnel, examining hearing difficulties, communication barriers, and current solutions using multiple-choice, Likert-scale, and open-ended formats. Quantitative and qualitative data were analyzed via descriptive statistics and summative thematic analysis.
RESULTS
Among 225 participants, 51 were nurses (23%), with 25% reporting hearing loss, 63% no hearing loss, and 12% uncertain. All nurses with baseline hearing loss reported auditory challenges in the operating room, while half without hearing loss reported frequent struggles during surgery (p<.0021). Nurses with > 5 years' operating room exposure had over 5-fold risk of hearing loss (95% confidence interval: 1.3-21.2; p=0.028). Noise from suction devices, alarms, and music hindered communication. Self-accommodations included asking for repetition (62%) and modifying the environment (32%). Nearly all respondents (96%) emphasized improving communication, supporting ambient noise reduction, technology, or behavioral interventions like closed-loop communication.
CONCLUSIONS
Operating room nurses, central to surgical safety and team efficiency, are disproportionately impacted by noise-related communication challenges. Their dual role positions them to lead the implementation of targeted noise mitigation and communication strategies, driving critical improvements in the surgical environment.
背景
手术室是医疗环境中噪音最大的场所之一，给患者安全、团队效率和手术结果带来了严峻挑战。手术室护士对患者护理和团队协作至关重要，他们面临着因噪音暴露和沟通障碍而产生的独特风险，但其面临的挑战仍未得到充分探索。
目的
从护士的角度评估手术室团队中的听力挑战和沟通障碍，探讨其对患者安全和干预措施的影响。
设计
横断面调查。
方法
向手术室人员发放电子调查问卷，通过多项选择题、李克特量表和开放式问题等形式，调查听力困难、沟通障碍及当前的解决方法。采用描述性统计和总结性主题分析对定量和定性数据进行分析。
结果
在225名参与者中，51名是护士（占23%），25%报告有听力损失，63%无听力损失，12%不确定。所有基线有听力损失的护士均报告在手术室存在听觉挑战，而半数无听力损失的护士报告在手术期间经常遇到困难（p<0.0021）。有超过5年手术室工作经验的护士听力损失风险超过5倍（95%置信区间：1.3-21.2；p=0.028）。吸引装置、警报器和音乐发出的噪音妨碍了沟通。自我调节措施包括要求重复（62%）和改变环境（32%）。几乎所有受访者（96%）都强调改善沟通，支持降低环境噪音、采用技术手段或实施如闭环沟通等行为干预措施。
结论
手术室护士对手术安全和团队效率至关重要，他们受到与噪音相关的沟通挑战的影响尤为严重。他们的双重角色使他们有能力引领针对性的噪音缓解和沟通策略的实施，推动手术环境的重大改善。
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