QUALITY IMPROVEMENT
Non-technical skills and device-related interruptions in minimally invasive surgery
Sahil Sharma, Teodor Grantcharov, James J Jung
Published by
Overview
This study investigated the relationship between non-technical skills (NTS) of operating room (OR) teams and device-related interruptions during laparoscopic surgeries. Using the OR Black Box®, researchers analyzed data from 144 elective laparoscopic operations over a 13-month period. They found that device-related interruptions occurred in 33% of the operations, with device failure being the most common type of interruption (54%).
The analysis revealed a significant association between the frequency of negative NTS instances demonstrated by nurses and the occurrence of device-related interruptions. After adjusting for potential confounders, each additional negative NTS instance by nurses increased the odds of a device-related interruption by 33%. This finding highlights the importance of improving non-technical skills, particularly among nursing staff, to potentially reduce device-related interruptions and enhance overall OR efficiency and safety.
Results
A total of 86 device-related interruptions occurred in 48 of 144 operations (33%). They were most frequently classified as device failure (54%) followed by improper assembly (19%) and disconnection (14%). Medians of 1 [interquartile range (IQR) 0-3] and 1 (IQR 0-2) negative NTS instance per operation were demonstrated by nurses and surgeons, respectively. Medians of 28 (IQR 15-38) and 40 (IQR 28-118) positive NTS instances per operation were demonstrated by nurses and surgeons. In a multivariable analysis, a higher frequency of negative NTS instances demonstrated by nurses was associated with device-related interruptions after risk adjustment (Odds Ratio 1.33, p = 0.02).
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