Electronic Distraction in the Operating Room: A Major Safety Issue

Authors

  • Jagroop Saran
  • Peter Papadakos

Keywords:

personal electronic devices (peds), distraction, sources of distraction, operating room

Abstract

The past decade has seen an increase in the use and availability of electronic devices, including computers and personal electronic devices, in the health care setting. Hospitals have invested significantly in electronic medical records and ensuring the availability of Wi-Fi and cellular networks throughout their institution. It remains to be seen if this increased accessibility has led to improved patient safety, or reduced medical errors, but it has led to a new, unanticipated, problem which may impact patient safety and professionalism.

The operating room (OR) is a complex and rapidly changing environment with high cognitive load tasks requiring teamwork and communication between team members and technology. Distractions, no matter how minor, have the possibility of causing errors which could result in patient harm. In this brief review the authors discuss potential sources of distractions in the operating room, explore some methods that have addressed this issue, and outline ways to limit electronic distractions.

Author Biographies

Jagroop Saran

Fellow, Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.

Peter Papadakos

Professor of Anesthesiology and Perioperative Medicine, Surgery, Neurology, Neurosurgery. University of Rochester School of Medicine and Dentistry, Rochester, New York, USA

References

http://www.nytimes.com/2011

/12/15/health/as-doctors-use-moredevices-

potential-for-distractiongrows.

html accessed November 20,

ECRI Institute. Top 10 health

technology hazards for 2013. Health

Devices Alerts 2012.

Charlton BG. The busy shall inherit

the earth: the evolution from “hard

work” to busyness in modern

science and society. Med

Hypotheses. 2006;67(5):1003–5.

Bryan L, Warner-Smith P, Brown P,

Fray L. Managing the work-life

roller coaster: private stress or

public health issue? Soc Sci Med.

;65(6):1142–53.

Brown S. Speed: facing our

addiction to fast and faster – and

overcoming our fear of slowing

down. New York: Berkley Books;

p. 336.

http://www.pewinternet.org/ factsheet/

social-media/ accessed

November 26, 2017

https://www.statista.com/topics/

/social-networking-in-canada/

accessed November 26, 2017

Strayer D, Drews F, Crouch D. A

comparison of the cell phone driver

and the drunk driver. Hum Factors.

;48(2):381.

Just MA, Keller TA, Cynkar J. A

decrease in brain activation

associated with driving when

listening to someone speak. Brain

Res. 2008;1205:70–80.

http://www.nsc.org/Distracted

DrivingDocuments/Attributable-

Risk-Estimate.pdf accessed

November 26, 2017

https://www.ontario.ca/page/

distracted-driving accessed

November 26, 2017

Revealed: The ‘mortified’ texting

shopper who fell in mall fountain…

and now she’s suing the security

guards who laughed at her. Daily

Mail. Available from:

http://www.dailymail.co.uk/news

/article-1348923/Texting-shopperfell-

mall-fountain-sues-securityguards-

laughing.html.

Woman falls into mall while texting.

YouTube. Available from:

https://www.youtube.com/watch?

v=2PrD8sUluVo.

Texting while walking claims

another victim: woman falls off pier.

Yahoo News. Available from:

http://news.yahoo.com/textingwhile-

walking-claims-anothervictim-

woman-falls-041406079.html.

Papadakos PJ. The rise of electronic

distraction in health care is

addiction to devices contributing. J

Anesthe Clinic Res. 2013;4:e112

Smith T, Darling E, Searles B. 2010

survey on cell phone use while

performing cardiopulmonary bypass.

Perfusion. 2011;26(5):375–80.

Smith T (presenter). Commentary

on: 2010 survey of cell phone use

during cardiopulmonary bypass.

Perfusion. 2011;26(6):381–382.

Papadakos PJ. Electronic

distraction: an unmeasured variable

in modern medicine. Anesthesiology

News. 2011;10:37(11).

Ewing JA. Detecting alcoholism.

The CAGE questionnaire. JAMA

;252(14):1905-1907.

Soto RG, Neves SE, Papadakos PJ,

Shapiro FE. Personal electronic

device use in the operating room: A

survey of usage patterns, risks and

benefits. European Journal of

Anaesthesiology (EJA). 2017 Apr

;34(4):246-7.

Nicholson E. Dallas anesthesiologist

being sued over deadly surgery

admits to texting, reading iPad

during procedures. Dallas Observer.

Available from: http://www.

dallasobserver.com/news/dallasanesthesiologist-

being-sued-overdeadly-

surgery-admits-to-texting

reading-ipad-during-procedures-

Operating Room Nurses Association

of Canada (ORNAC) Standards for

Perioperative Registered Nursing

Practice (13th edition April 2017)

Section 4, p.367, Standard 4.37.

Association of periOperative

Registered Nurses (AORN).

Managing distractions and noise

during perioperative patient care.

Available from: www.aorn.org/-

/media/aorn/guidelines/positionstatements/

posstat-safetydistractions-

and-noise.pdf.

American Society of

Anesthesiologists Committee on

Quality Management and

Departmental Administration.

Statement on Distractions 2015.

Available from: http://www.asahq.

org/~/media/sites/asahq/files/

public/resources/standardsguidelines/

statement-on-distractions.

pdf#search=%22distractions%22.

College’s Committee on Perioperative

Care. Statement on distractions in the

operating room. Bull Am Coll Surg.

;101(10):42–4. 2016 Oct 1.

Available from: http://bulletin.facs.

org/2016/10/statement-ondistractions-

in-the-operating-room/.

Wadhera RK, Parker SH, Burkhart

HM, et al. Is the “sterile cockpit”

concept applicable to cardiovascular

surgery critical intervals or critical

events? The impact of protocoldriven

communication during

cardiopulmonary bypass. J Thorac

Cardiovasc Surg. 2010;139(2):312–9.

Lee BT, Tobias AM, Yueh JH, et al.

Design and impact of an

intraoperative pathway: a new

operating room model for teambased

practice. J Am Coll Surg.

;207(6):865–73.

Published

2018-06-01

How to Cite

Saran, J., & Papadakos, P. (2018). Electronic Distraction in the Operating Room: A Major Safety Issue. Operating Room Nurses Association of Canada Journal, 36(2), 12–18. Retrieved from https://ornacjournal.ca/index.php/ornac/article/view/12099

Issue

Section

Feature Articles