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An observational study of distractions in the operating theatre
Several studies have reported on the negative impact of interruptions and distractions on anaesthetic, surgical and team performance in the operating theatre. This study aimed to gain a deeper understanding of these events and why they remain part of everyday clinical practice. We used a mixed metho...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891421/ https://www.ncbi.nlm.nih.gov/pubmed/33252139 http://dx.doi.org/10.1111/anae.15217 |
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author | van Harten, A. Gooszen, H. G. Koksma, J. J. Niessen, T. J. H. Abma, T. A. |
author_facet | van Harten, A. Gooszen, H. G. Koksma, J. J. Niessen, T. J. H. Abma, T. A. |
author_sort | van Harten, A. |
collection | PubMed |
description | Several studies have reported on the negative impact of interruptions and distractions on anaesthetic, surgical and team performance in the operating theatre. This study aimed to gain a deeper understanding of these events and why they remain part of everyday clinical practice. We used a mixed methods observational study design. We scored each distractor and interruption according to an established scheme during induction of anaesthesia and the surgical procedure for 58 general surgical cases requiring general anaesthesia. We made field notes of observations, small conversations and meetings. We observed 64 members of staff for 148 hours and recorded 4594 events, giving a mean (SD) event rate of 32.8 (16.3) h(‐1). The most frequent events observed during induction of anaesthesia were door movements, which accounted for 869 (63%) events, giving a mean (SD) event rate of 28.1 (14.5) h(‐1). These, however, had little impact. The most common events observed during surgery were case‐irrelevant verbal communication and smartphone usage, which accounted for 1020 (32%) events, giving a mean (SD) event rate of 9.0 (4.2) h(‐1). These occurred mostly in periods of low work‐load in a sub‐team. Participants ranged from experiencing these events as severe disruption through to a welcome distraction that served to keep healthcare professionals active during low work‐load, as well as reinforcing the social connections between colleagues. Mostly, team members showed no awareness of the need for silence among other sub‐teams and did not vocalise the need for silence to others. Case‐irrelevant verbal communication and smartphone usage may serve a physical and psychological need. The extent to which healthcare professionals may feel disrupted depends on the situation and context. When a team member was disrupted, a resilient team response often lacked. Reducing disruptive social activity might be a powerful strategy to develop a habit of cross‐monitoring and mutual help across surgical and anaesthetic sub‐teams. Further research is needed on how to bridge cultural borders and develop resilient interprofessional behaviours. |
format | Online Article Text |
id | pubmed-7891421 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78914212021-03-02 An observational study of distractions in the operating theatre van Harten, A. Gooszen, H. G. Koksma, J. J. Niessen, T. J. H. Abma, T. A. Anaesthesia Original Articles Several studies have reported on the negative impact of interruptions and distractions on anaesthetic, surgical and team performance in the operating theatre. This study aimed to gain a deeper understanding of these events and why they remain part of everyday clinical practice. We used a mixed methods observational study design. We scored each distractor and interruption according to an established scheme during induction of anaesthesia and the surgical procedure for 58 general surgical cases requiring general anaesthesia. We made field notes of observations, small conversations and meetings. We observed 64 members of staff for 148 hours and recorded 4594 events, giving a mean (SD) event rate of 32.8 (16.3) h(‐1). The most frequent events observed during induction of anaesthesia were door movements, which accounted for 869 (63%) events, giving a mean (SD) event rate of 28.1 (14.5) h(‐1). These, however, had little impact. The most common events observed during surgery were case‐irrelevant verbal communication and smartphone usage, which accounted for 1020 (32%) events, giving a mean (SD) event rate of 9.0 (4.2) h(‐1). These occurred mostly in periods of low work‐load in a sub‐team. Participants ranged from experiencing these events as severe disruption through to a welcome distraction that served to keep healthcare professionals active during low work‐load, as well as reinforcing the social connections between colleagues. Mostly, team members showed no awareness of the need for silence among other sub‐teams and did not vocalise the need for silence to others. Case‐irrelevant verbal communication and smartphone usage may serve a physical and psychological need. The extent to which healthcare professionals may feel disrupted depends on the situation and context. When a team member was disrupted, a resilient team response often lacked. Reducing disruptive social activity might be a powerful strategy to develop a habit of cross‐monitoring and mutual help across surgical and anaesthetic sub‐teams. Further research is needed on how to bridge cultural borders and develop resilient interprofessional behaviours. John Wiley and Sons Inc. 2020-08-17 2021-03 /pmc/articles/PMC7891421/ /pubmed/33252139 http://dx.doi.org/10.1111/anae.15217 Text en © 2020 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles van Harten, A. Gooszen, H. G. Koksma, J. J. Niessen, T. J. H. Abma, T. A. An observational study of distractions in the operating theatre |
title | An observational study of distractions in the operating theatre |
title_full | An observational study of distractions in the operating theatre |
title_fullStr | An observational study of distractions in the operating theatre |
title_full_unstemmed | An observational study of distractions in the operating theatre |
title_short | An observational study of distractions in the operating theatre |
title_sort | observational study of distractions in the operating theatre |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891421/ https://www.ncbi.nlm.nih.gov/pubmed/33252139 http://dx.doi.org/10.1111/anae.15217 |
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