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ADVANCE Perspective: Nurses

Do Cell Phones Belong in the OR?

Published April 3, 2014 2:15 PM by Robin Hocevar

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 addictions.

·         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 the morning?

·         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 issue.”

Obviously, banning 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?

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