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Communication Failures and the Influence of Noise in the Operating Room: A Prospective Cohort Study
Louise Grant1,2, Patricia Nicholson3, Bronwyn Davidson4
1Department of Nursing, Melbourne School of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
None:
Effective communication is essential between health professionals during surgical procedures for delivery of safe patient care. The influence of noise on communication during critical moments of surgery and on communication failures is unclear.
Aim:
To examine communication events among health professionals in the operating room and investigate the influence of noise on communication.
Methods:
Non-participatory observations were undertaken of communication between health professionals during surgical procedures while simultaneously measuring sound pressure levels. Audio visual recording was used to document communication events, ensuring data accuracy. A generalised linear mixed model was used to examine relationships between various explanatory variables and the presence of at least one communication failure. The STROBE checklist guided the reporting of this paper.
Results:
A representative range of procedures was observed from diverse surgical specialties (N = 80). Observations comprised 2274 communication events; communication failures were observed in 24% and repeated communication was observed in 25% of all communication events. The mean maximum sound pressure levels were 64.9 dB[A] for communication events, 64.5 dB[A] for communication failures and 65.5 dB[A] for repeats. The type of surgical procedure, the emergence from anaesthesia compared to other phases of surgery, communication related to the surgical safety checklist, communication related to the surgical count, the presence of multitasking, and the use of surgical facemasks, were associated with the presence of at least one communication failure.
Conclusions:
This research identified the inherent risks and occurrence of communication failure in noisy operating room environments where health professionals are undertaking complex cognitive tasks and where effective communication is essential to ensure patient safety.
Patient Or Public Contribution:
This study did not include patient or public involvement in its design, conduct, or reporting.
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