SAFETY CULTURE
Factors associated with surgeon's perception of distraction in the operating room
Published on
July 1, 2020
Surgical Endoscopy
Overview
This study investigated factors contributing to surgeons feeling distracted during operations, a concern due to its potential impact on patient safety. Researchers analyzed 265 laparoscopic general surgeries using the OR Black Box® and surgeon surveys. They found that surgeons reported feeling distracted in 45% of operations, with various auditory and cognitive distractions present.
Multivariable analysis revealed two factors independently associated with increased likelihood of surgeons feeling distracted: irrelevant conversations in the operating room and patients having a history of previous abdominal surgery. The study concludes that irrelevant conversation is a modifiable factor that significantly contributes to surgeon distraction, suggesting a potential area for improvement in operating room practices to enhance patient safety.
Results
The attending surgeon reported feeling distracted in 120 of 265 operations (45%). Auditory sources of distraction, such as the OR door opening occurred at a median of 41 times per case (interquartile range (IQR), 32-54). Cognitive distractions such as teaching (142 cases (54%)), device malfunction (91 (34%)), irrelevant conversations (72 (27%)), management of the next case (41 (15%)), and time pressure (22 (8%)) occurred in a significant number of operations. In a multivariable analysis, presence of irrelevant conversations (odds ratio 2.14, 95% confidence interval (CI) 1.16-3.94, p = 0.015) and patient history of previous abdominal surgery (odds ratio 2.2, 95% CI 1.18-4.1, p = 0.013) were independently associated with increased likelihood of the surgeons feeling distracted.