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Publish Date: 9/18/2013

 A 4-step program to stop eDevice distraction


Smartphone addiction has become a cultural norm and it’s infiltrating every perioperative setting, from acute care to ambulatory surgery centers.

Distracting ring tones interrupt OR communication. A surgeon’s medication orders are forgotten when he gets an email alert. A scrub nurse must call to the RN circulator several times during a case to draw her attention away from an internet search. These are real distractions that have left patients injured and vulnerable to harm.

“People have become so used to their fixation on their personal electronic devices, that they are not even aware of a breakdown in their professional behavior,” says Peter J. Papadakos, MD, FCCM, FAARC, an anesthesiologist and director of critical care medicine at the University of Rochester Medical Center in New York.

Papadakos has popularized the term “distracted doctoring,” but he stresses it’s not just doctors—“it’s distracted everybody on the health care team.” He says the need for constant electronic stimulation and hyper socialization has become a paradigm shift in our culture that health care providers are not immune to.

Compounding this problem is the fact that important patient information is increasingly transmitted through personal electronic devices, so a surgeon could be checking texts or emails to get an update on a patient, but has to wade through messages from family and junk mail advertising to find it. Thus, the surgeon is responding to every alert and not just patient care data.

“Our patients deserve better.” Papadakos has taken this message to the national news circuit and to hospitals and ORs across the country in his mission to stop eDevice distraction. That’s why AORN is collaborating with Papadakos to update AORN’s position statement on noise with new suggestions for preventing eDevice distractions during critical moments in perioperative care.

Papadakos shares his 4-step program to stop eDevice distraction:

Step 1: Raise Awareness
Help people understand eDevice addiction and show them how to modify behavior.
Ask these modified CAGE Questions used for alcohol addiction to assess addiction (for yourself and your staff) to personal electronic devices (PED):

  • Have you ever felt you needed to cut down on use of your PED?
  • Have people annoyed you by criticizing your use of PED?
  • Have you felt guilty about your overuse of your PED at work?
  • Do you reach for your PED first thing in the morning?
Help establish healthy eDevice habits, such as:

  1. Silencing smartphones when entering the workplace
  2. Talking to family and friends about limiting non-essential communication (including texts) during work hours
  3. Restricting smartphone use to lounges, allowing only patient-related calls in the OR 
Step 2: Build and enforce strict eDevice policy
Establish detailed rules for eDevice use in all patient care areas.
A good eDevice Code of Conduct should:

  • Clarify expectations for all staff to monitor themselves and their colleagues’ eDevice conduct
  • Outline standard practice for separate use of all personal and hospital-issued eDevices in the workplace
  • Establish how clinicians will explain to patients their use of hospital-issued eDevices for medical management (in preoperative and postoperative settings) to help the patient understand staff members are focused on patient care
Step 3: Create sacred space where eDevices are not permitted
Implement a No Interruption Zone.
Establish clear rules with every member of the surgical team to ensure NO interruptions from eDevices during these critical phases of the operative procedure:

Induction
Emergence
Time outs
Counting
Step 4: Teach by example
Be self-aware of eDevice behavior, follow established rules at work and practice good eDevice etiquette outside of work.

  • Make sure staff see you following your eDevice policy—no exceptions.
  • Extend this eDevice etiquette to all work interactions—no checking your email during meetings.
  • Develop healthy eDevice habits in your personal life; don’t text while driving and don’t look at your phone during face-to-face conversations.
Additional Resources

Read an editorial by Dr. Papadakos on eDevice addiction:
“The Rise of Electronic Distraction in Health Care is Addiction to Devices Contributing”

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