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02-09-2010 | Anaesthesiology | Article

Frequent distractions impact anesthesia practice

Abstract

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MedWire News: Distracting events almost invariably occur during general anesthesia induction, say researchers who found that a fifth of these negatively affect patient management.

"The findings bear out the general impression of professionals: distracting events and interruptions are frequent during this phase of anesthesia when calm and vigilance should prevail," say Georges Savoldelli (Geneva University Hospitals, Switzerland) and colleagues.

The team filmed 37 general anesthesia inductions for patients requiring urgent surgery. A total of 29 anesthesiology team members were involved. During inductions lasting a median of 8.3 minutes there were a median of five distracting events, with a range of one to 14.

At least one distracting event was present for almost 40% of the induction time, and 82.8% of all events had an observable impact on at least one anesthesiology team member.

The researchers divided distracting events into "internal" and "external." They note: "The distinction between internal and external distracting events is important because it allows us to better understand on which distracting events we may act."

Intrusion of external staff was the most frequent distraction, accounting for 28.7% of instances overall. This, explains the team, is because the anesthesia induction room is a transit room for patients leaving surgery and also houses equipment required in surgery.

However, distractions caused by external staff caused the shortest disturbances. In contrast, external distractions from phones or bleepers were infrequent, but caused longer interruptions. External distractions very rarely affected patient management.

The longest interruptions came internally, from problems with equipment such as pulse oximetry probes. This most often resulted in a task being performed suboptimally.

But the most frequent internal distractions came from inappropriate behavior of the team members themselves. These accounted for 24% of the total distractions, and included many "inappropriate conversations."

Other internal distractions arose from patients, alarm monitoring, and workspace constraints. A third of internal distractions (22% of the total) had negative consequences, such as a suboptimally performed task resulting in inadequate pre-oxygenation.

"Future research should be oriented towards the development and implementation of various approaches such as those used in the aviation industry, first to minimize the occurrence of unnecessary distracting events and second to promote coping strategies such as effective multitasking and prioritizing," conclude Savoldelli et al.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Eleanor McDermid