Interruptions and distractions in the gynaecological operating theatre: irritating or dangerous?

Distractions and interference can include visual (e.g. staff obscuring monitors), audio (e.g. noise, irrelevant communication) and equipment problems. Level of distraction is usually defined as I: relatively inconsequential; II: > one member of the surgical team affected; III: the entire surgical team affected. The aim of this study was to observe the frequency and impact of distracting events and interruptions on elective gynaecology cases. Data from 35 cases were collected from 10 consecutive operating sessions. Mean number of interruptions was 26 episodes/case, while mean number of level II/III distractions was 17 episodes/case. Ninety per cent of interruptions occur in the first 30 minutes of the procedure and 80.9% lead to level II/III distraction. Although no complications were directly attributable to the observed distractions, the mean prolongation of operating time was 18.46 minutes/case. Understanding their effects on theatre environment enables appropriate measures to be taken so that theatre productivity and patient safety are optimised. Practitioner Summary: This observational study of 35 elective cases shows a mean interruption rate of 26 episodes/case with 80.9% affecting > one member of operating team, leading to mean prolongation of 18.46 minutes/case. Theatre staff should be aware of these findings and appropriate measures taken to optimise theatre productivity and patient safety.