Cognitive Factors Influencing The Management Of Interruptions During Surgical Counts

Abstract

Interruptions during surgical counts are critical gateways for adverse events to happen. It is important to understand the cognitive strategies nurses employ during interruptions of counts and to reduce the likelihood of adverse events. 45 counts of interruptions out of 141 surgical counts throughout 20 surgeries were recorded using an eye tracking system on 20 scrub nurses. It was observed that 62 % of the interruptions occurred during the closure count – one of the most important counts during a surgical procedure. An evaluation of the nature of the interruptions highlighted 5 main categories of interruptions, with 40% involving failure in working memory, and 53 % involving active task prioritization that led to the break in task. The categories of interruptions were grouped under three key cognitive factors influencing effective interruption management and discussed. The three cognitive factors include ‘working memory’, ‘active task prioritization’ and ‘prospective memory’. Future work includes secondary analysis on the surgical count videos, and post experimental interviews with the scrub nurses.