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• W2319308049 abstract "Interruptions and non-operative distractions during surgery may lead to surgical errors and are associated with poorer outcomes within many surgical specialities. Lung transplantation’s multi-disciplinary nature and its inherent complexity makes it more vulnerable to theatre distractions. We aimed to investigate the frequency and severity of distracting events during lung transplantation and its impact on post-operative complications. A prospective study was undertaken by direct observation of distractions and interruption events during lung transplantations. Theatre team was ‘blinded’to the study. Events were identified and assessed using the Imperial College Error Capture tool(ICECAP). ICU & hospital stay, pleural space infections, bleeding and anastomotic complications were correlated with the number and severity of distracting events. 287 hours was observed across 41 lung transplants (36 bilateral & 5 single lung transplants) from August 2011 to August 2014. We recorded 2059 interrupting or distracting events. Surgeons were consciously aware of 19.2% of recorded events. 61% were due to procedure-independent pressures, 15% were due to equipment problems, 12% were due to communication issues (misunderstandings or inability to hear each other) and the remainder were associated with technical problems or patient-safety concerns. 83% of procedure-independent pressures were non-operative distractions. Common causes of non-operative distractions were ringing telephones and patient-unrelated discussions. 9% were caused by staff absences at a critical moment of surgery. The number and severity of distracting events were positively correlated with post-operative bleeding (p<0.01), anastomotic complications(p<0.03) and prolonged ICU stay (p=0.002) but not with pleural space infection(p=0.2) or hospital stay (p=0.08). Surgeons were often unaware of the large number of distractions and interruptions whilst operating. Situational awareness must be raised to provide a safer operating environment. Greater numbers of distractions and interruptions were associated with more anastomotic complications, re-operations for bleeding and longer ICU stay. NOTSS or FOCUS frameworks may be implemented to reduce theatre distractions and interruptions to improve patient outcomes." @default.
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• W2319308049 date "2015-04-01" @default.
• W2319308049 modified "2023-10-14" @default.
• W2319308049 title "Distractions During Lung Transplantation Surgery - Do Interruptions Matter?" @default.
• W2319308049 doi "https://doi.org/10.1016/j.healun.2015.01.646" @default.
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