Examining Interruptions in the Operating Room Using Simulation

Abstract

© 2018 International Nursing Association for Clinical Simulation and Learning Background: Several patient safety organizations have acknowledged that interruptions may be a contributing factor in medical error. Studies examining individual cognitive reactions to interruptions are lacking, which hinders the development of effective interventions to reduce interruptions. Methods: A mixed-methods study was conducted including observations (n = 15), participation in high-fidelity simulations (n = 30), and debriefing interviews with participants after completion of the simulation exercise. Results: Experienced nurses more frequently violated policy in terms of allowing interrupting events to continue during time-out procedures (p <.003). Results from debriefing interviews indicated that participants used two cognitive strategies to manage distractions and interruptions. Conclusions: This study showed that there were frequent distractions and interruptions during critical tasks in the operating room. It also supports the use of high-fidelity simulation as a tool to examine circulating nurses' decision-making in management of distractions.