The impact of distractions and interruptions in the operating room on patient safety and the operating room team: An integrative review

Abstract

Problem identification: In the operating room (OR), distractions and interruptions are frequent, impacting patient safety, coordination and efficiency and causing errors and patient harm. The OR team is impacted while attempting to perform critical work. This review explores the impact of distractions and interruptions in the OR on patient safety and the OR team. Literature search: Inclusion and exclusion criteria were determined. Six databases were searched with the search criteria for inclusion being in English, peer-reviewed and published between 2014 and 2019. In total 296 papers were identified. Data evaluation synthesis: Duplicates were removed, and 195 papers were screened using inclusion and exclusion criteria. Fourteen studies were included in the review: 12 were quantitative reviews and two were mixedmethod reviews. Methodological quality was assessed using the mixed methods appraisal tool (MMAT), with scores between 60 and 90 per cent. A thematic analysis revealed observational study themes of types, frequency and severity of distractions and interruptions, and impacts upon mental workload, patient safety and the OR team. Simulation study themes included types of distractions and interruptions, and impact on mental workload, clinical decision-making, surgical performance and nurses. Implications for practice or research: The heterogeneity of the literature and paucity of recent nursing and anaesthetic studies highlights that further research is necessary. Nurses can educate and develop policies and interventions to reduce distractions, enhancing patient safety and decreasing the negative impact upon their colleagues and teams.