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BUSINESS

Managing Operating Room Distractions

By Kirsten Baze, RPLU, ARM

an operating room (OR), patient safety can be com- tions unrelated to the surgical procedure, telephone calls, technology
In promised when surgical team members are distracted. use, and music.(1) These noises can lead to ineffective communica-
tion; diminished signal and speech intelligibility; poor performance
Diligent concentration, vigilance, and clear commu-
nication are paramount in completing the intricate and of complex tasks; poor cognitive function and concentration; and
complex tasks required in surgery. However, noise — a significant stress, fatigue, and anxiety.(2)
distraction in the OR — is a given in this setting. The concept of the “sterile cockpit,” which mandates elimination
Sources of noise in an OR include medical equipment devices (e.g., of nonessential activities during aircraft takeoffs and landings, can
monitors, clinical alarms, and other alerts), fixed communication de- be applied in the OR. Protocols similar to the sterile cockpit can be
vices (e.g., overhead announcements and landline telephones), envi- created to ensure the least amount of noise and distractions occur
ronmental devices (e.g., HVAC systems and pneumatic tube systems), during critical periods of the surgical procedure.(3) Some examples
electronic activities by OR staff (e.g., texting, internet browsing, etc.), of critical times during surgery include the induction and emergence
and healthcare personnel entering and leaving the room. of anesthesia, clipping of an intracranial aneurysm, and initiation
The most commonly cited distractions in the OR are conversa- of cardiopulmonary bypass.

34 San Antonio Medicine • September 2018