Turn Down the Noise in the OR

Miscommunication is a frequently cited cause of preventable medical error, A new study finds that ambient background noise, whether it is loud equipment, talk among team members, or music, is a patient and surgical safety factor that can affect auditory processing among surgeons and surgical team members in the operating room (OR). The findings, published in the May 2013 issue of the Journal of the American College of Surgeons, suggest that a surgeon’s ability to understand spoken words in the OR is directly affected by environmental noise.

Study coauthor Matthew Bush, MD, assistant professor of surgery at the University of Kentucky Medical Center in Lexington, said it is essential to carefully consider the listening environment in the OR in order to minimize communication errors.

The researchers tested the effects of ambient noise on OR communication by creating a noise environment similar to that in an OR, and testing 15 surgeons with 1 to 30 years of experience. Surgeons’ ability to understand and repeat words was tested via the Speech in Noise Test-Revised (SPIN-R) under 4 different listening conditions typical of OR environments: quiet, filtered noise through a surgical mask, and background noise both with and without music. Surgeons were tested while engaged in a specific surgical task and when task free.

The study showed a significant decrease in speech comprehension when there was background noise when the words were unpredictable and considerably poorer speech comprehension in the presence of music, compared with a quiet environment or one with OR noise present. The addition of music became a significant barrier to speech comprehension only when the surgeon was engaged in a task, the researchers said.

The study concluded that OR noise can cause a decrease in auditory processing, particularly in the presence of music. In addition, the ability to understand what is said becomes more difficult when the conversations contain critical information that is unpredictable.