Intraoperative Distractions and Impact on the Surgical Team

Objective: This study aimed to determine the types and frequency of distractions that occur during surgery and to evaluate their impact on the surgical team.Methods: This prospective cross-sectional study was conducted at the Sancaktepe Şehit Prof.Dr. İlhan Varank Training and Research Hospital in Istanbul, Türkiye. Planned surgeries performed in the hospital between 10.10.2022-21.10.2022 within a 10-day period were observed. The Distractions in the Operating Room Observation Form, which was created by the researchers in line with the opinions of the operating room staff, observations and literature, was used to evaluate the distractions. Each distracting event from the first skin incision to skin closure was recorded. The effects of the observed distractions on the surgical team were evaluated with the “Visual Analog Scale”.Results: Forty-five elective cases were observed for a total of 5908 minutes. Abdominal surgery accounted for 40% of the observed cases. Other cases were neurosurgery, orthopedic surgery, cardiac surgery, breast surgery and head and neck surgery. A total of 1050 distracting events and 194 distracting situations occurred during the observation period. A mean of 10.7 distracting events were observed per hour. The most common distractions were the opening of the operating room door (n=573), telephone ringing (n=170) and telephone calls (n=129). A total of 229 team members (90 surgeons, 49 scrub nurses, 45 circulating nurses, 45 anesthesiologists) participated in the surgeries. The level of being affected by distractions differed between disciplines and anesthesiologists were less affected than surgeons and nurses.Conclusion: The findings showed that the most frequent recurring distractions were for preventable reasons and that the distractions with the greatest impact on the surgical team were sudden and unexpected events.