Reducing Noise Pollution in the Operating Room During Critical Phases of Anesthesia

Abstract

Introduction/Purpose: Noise pollution in the Operating Room (OR) has been a problem since the 1970's. Noise levels have been recorded much higher than recommended which can lead to distractions during the anesthesia induction and emergence phases. The purpose of this project is to evaluate if the perceived level of noise in the OR, level of distraction, and level of stress for the anesthesia provider is improved after an educational Toolkit is implemented for the OR staff. Review of the literature: Research shows that noise levels and number of distractions during anesthesia induction and emergence are far too high. Studies have been conducted to implement educational interventions in order to decrease noise levels and number of distractions during these periods, and they have shown significant improvement. Methods: A Toolkit was developed to encourage staff to add a cue into the pre-anesthesia verification and period at the end of the surgical case. In addition, the operating room staff and anesthesia staff were provided with an education module on the topic of noise pollution in the OR with a specific focus on the anesthesia induction and emergence phases. Results: Utilizing a repeated cross sectional design data analysis, data revealed results both consistent and inconsistent with previous research. There was even distribution among the different OR cores, and unequal distribution among providers who filled out the data collection surveys with CRNAs participating more frequently than resident physicians. There was a decrease in unnecessary conversations and occurrence of loud noises during induction When compared using p-values, there was only a statistically significant change in occurrence of unnecessary conversations (p = 0.0009). When combining the two categories, there was a total of a 20.7% decrease in occurrence. Music playing during induction and emergence decreased after intervention but not to a statistically significant level. There was an increase in unnecessary conversations during emergence to a statistically significant level. There was a decrease in the occurrence of loud noises during emergence, but not to a statistically significant level. A majority of participating anesthesia providers (64.62%) felt that the educational intervention improved clinical care during critical anesthetic periods. Discussion: This project revealed that it is possible to decrease noise and distractions by implementing an educational intervention. The results did not show as much improvement as revealed in other studies. This is possibly from COVID-19 limitations causing changes to be made to the implementation of the educational intervention. Data may have also been different than expected due to the providers who filled out the surveys becoming more aware of noises and conversations as participation continued on throughout the project. Statistically significant changes during the induction period and not during emergence may have been due to the presence of an anesthesia pre-induction verification that creates a natural pause in the room. Plan: This project had pre- and post- intervention data collection through surveys that were filled out by the anesthesia provider just after induction and just after emergence. This survey had yes and no questions about the presence of noise and distractions during induction and emergence that has been borrowed with permission from another study. Two additional questions about the impact of the noise and distractions are asked and measured on a Likert scale.