Do Cell Phones Belong in the OR?
If there’s any question
about our collective dependence on cell phone, Peter J. Papadakos, MD, FCCM,
FAARC, anesthesiologist and director of critical care medicine at University of
Rochester Medical Center in New York, created a symptom checklist. You may
recognize the questions, as they’re adapted fror the screener for alcohol
· Have you ever felt a need to cut down on use of
your personal electronic device?
· Do you reach for the cell phone first thing in
· Do people annoy you by criticizing your use of a
personal electronic device?
· Have you felt guilty about your overuse of your
personal electronic device at work?
At the conclusion of its
2014 Surgical Conference and Expo, the American Association of periOperative
Nurses (AORN) approved a position statement on distraction and noise in the
operating room. The paper recognizes critical phases in surgical procedures
like time out period, critical dissections, surgical counts, confirming and
opening implants, care and handling of specimens and induction and emergence
from anesthesia when the environment should be as quiet as possible.
Though cell phones
aren’t the only distraction, Donna Ford, MSN, RN-BC, CNOR, CRCST, member of
AORN’s clinical practice committee noted a surge in use of personal electronic
devices in hospitals. She presented a 2012 statistic affirming that 80% of
doctors use cell phones in the hospital.
Just this year, the
Pennsylvania Patient Safety Authority’s report concluded 13 serious events
could be attributed to technology distraction.
“The more distractions
we have, the less time we’re spending running through the items on our safety
checklist,” said Ford. “The checklists were created to have the opposite effect
and give us a reason to stop and think.”
Judging by the crowds
surrounding the Google Glass display at AORN, technological devices in the OR
aren’t going away anytime soon.
AORN now joins the
American Association of Nurse Anesthetists (AANA) and American College of
Surgeons (ACOS) in crafting official positions on OR noise and cell phones in
particular. ACOS said OR noise disrupts doctors’ auditory processing ability.
That’s not to say cell
phones in the OR can’t be useful. Approximately 25% of the audience in a one of
AORN’s highlight sessions on this topic said doctors ask nurses to text, not
page, them when the surgical suite is ready. Others use medical apps.
The clinical application
of cell phones makes it hard for institutions to verify staff violations, said
one attendee. Many accused of using their phone unnecessarily say they were
communicating with the doctor or looking up information. Short of confiscating
phones and reviewing data history (which can be subpoenaed should a lawsuit
occur), managers grapple with enforcing policies.
Then there’s the issue
of handling the doctor’s phone.
“Somehow, nurses have
become the gatekeepers of doctors phones and it’s affecting our practice,” said
an audience member, who was applauded for voicing this concern. “Someone else
needs to absorb this responsibility because it’s become a patient safety
phones in hospitals isn’t realistic. Is cell phone use by staff a problem in your
facility? What policies have been effective in governing cell phone use?