Thursday, May 5, 2011

Focusing on patient needs in the OR

I had a great conversation with a group of OR nurses last week.  We were talking about "multitasking" in the OR, and how we wanted to make sure our attention was on our patient during critical times.  It's not always as simple as just saying "Let's pay attention".  There are a lot of subtle factors at play.

Some interesting suggestions and comments came out of the discussion:

Agree on a “safe” word/phrase that anyone could use to remind everyone in the room to focus on the task at hand.  One suggestion was “focus”.  The word  would have to be non-judgmental and non-threatening.

Perhaps part of the surgical checklist could be stating a commitment/reminder that everyone in the room would be attentive to the patient’s needs.
Concern that some people may take such reminders personally and be upset with the other person.  This subtly intimidates people into keeping their concerns to themselves.
There is a mix of people in the room including nurses, surgeons, anaesthetists, residents, students and there are often lots of conversations going on.  Who can judge which conversations are important for patient care and which ones could wait until later?
Maybe we should set aside “critical times” like takeoff and landing a plane where conversations are only about the task at hand, ie safe patient care
Staff noted that patients may overhear “inappropriate” conversations while they are awake and it may be upsetting to them.  Even though their surgical outcome may be good, they may be left with an overall bad impression of their care.

We didn't solve anything that morning, but I was encouraged to hear the level of interest in pursing this opportunity to improve patient care.  Next step: gather suggestions from the entire OR staff.  Maybe an invitation to discuss this at a weekly inservice meeting?  Hint, hint.

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