Can You Hear Me? 3 Reminders to Reduce OR Distractions

Are personal cell phones alerting staff to non-essentials calls or messages in your ORs? Are you noticing an uptick in non-essential interruptions or communications across your surgical setting?

Too often nurses, surgeons and other members of the surgical team can get so caught up in the fast pace of surgical care that they become immune to the distractions that can hamper team communication and lead to adverse patient safety events, cautions Lisa Spruce, DNP, RN, ACNP, CNOR, CNS-CP, ACNS, FAAN, director of Evidence-Based Perioperative Practice at AORN.

Recognizing Dangerous Distractions

“Distractions come from components necessary for patient care, such as equipment alarms, telephones, cell phones, pagers, and equipment noise. However, other distractions occur in the environment that are not necessary for patient care,” she says, “such as irrelevant conversations, music, and interruptions from personnel not essential to the procedure.”

Decreasing Noise Pollution

There are ways to decrease distractions and leaders play an important role in reminding staff to be aware and decrease distractions in all areas of surgical care, whether in the OR, preop or PACU, and even in sterile processing.

Spruce suggests three easy reminders nurse leaders can emphasize with teams to ensure distractions aren’t risking patient safety and team collaboration:

1. Clear Non-Essential Noise Pollution

   OR traffic and noise pollution can easily increase without team members taking notice, she notes. “Emphasize the importance of limiting non-essential conversations, muting cell phones or limiting their use, and limiting the number of people in the OR.”



2. Re-Evaluate the Volume and Frequency of Necessary Noise

   While a certain level of noise in surgical care is required, Spruce says leaders can work with team members to make these noises quieter. For example, “by decreasing the use of overhead paging, keeping equipment alarms and alerts to the lowest levels that remain audible, and reminding staff to control their voice level and tone.”



3. Reiterate Safe Cell Phone Use

   Recognizing that some facilities allow surgical team members to carry their personal cell phone with them, Spruce suggests regular reminders about safe cell phone use can be helpful. “Personal devices may add to the overall noise pollution in the OR, which can distract personnel from clear communication and safe patient care.”

To minimize distractions during critical phases of the procedure, such as the time out, anesthesia induction and emergence, surgical counts, and specimen management, personal devices should be left outside the OR, turned off, placed on vibrate or silent mode, and handled only when needed.

Looking for evidence on distractions to share with your team? Review AORN’s Position Statement on Distractions and Noise in the Perioperative Practice Setting and share this August 2019 Clinical Issues from AORN Journal that discusses Cell Phone Use in the OR.

Free Resources for Members

Educate your staff and minimize distractions in your OR with tools available in Guideline Essentials.

• Download an in-service presentation template on the Guideline for Environment of Care, which includes three techniques to minimize noise and distractions.
• Download a customizable policy & procedures template on the Guideline for Team Communication to establish how to handle distractions in the OR.
• Read Implementing No Interruption Zones in the Perioperative Environment, M. Wright, 2016 104(6)

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