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.

Application of eye‐tracking in nursing research: A scoping review

“…Koh, Tay, et al. ( 2011 ) identified the cognitive factors influencing the management of interruptions.…”

“…Fifty‐one studies included nurses as participants, involving ICU nurses (Ahmadi et al., 2022 ; Buehler et al., 2021 ; Henneman, Gawlinski, et al., 2017 ; Hofmaenner et al., 2021 ), psychiatric nurses (Chiba et al., 2021 ), coronary care nurses (Currie et al., 2018 ; Lavoie et al., 2023 ), scrub nurses (Afkari & Bednarik, 2023 ; Koh et al., 2009 ; Koh, Park, et al., 2011 ; Koh, Tay, et al., 2011 ), neonatal nurses (Law et al., 2018 ; Law & Schmolzer, 2020 ; Wagner et al., 2022 ), nurse anaesthetist (Badeaux, 2015 ), emergency nurses (Henneman et al., 2012 ).…”

Work interruptions and missed nursing care: A necessary evil or an opportunity? The role of nurses’ sense of controllability

“…Our findings also have important theoretical implications for the field of MNC. Scholars agree that MNC largely arises from scarce resources, thus interfering with a nurse's working memory, namely through a limited capacity to retain information for a brief period while performing mental operations (Harris & Wilkins, 1982; Koh et al., 2011; McDaniel & Einstein, 2000). These scholars argued that interfering with working memory may exceed nurses’ capacity to address patients’ needs, thus triggering MNC (Aiken et al., 2018; Palese et al., 2015).…”

“…Concomitantly, proactive team huddles during the shift can also help nurses discuss the tasks that were not completed and organize to complete them (Franklin et al., 2020). Finally, prioritization is a cognitive skill that can be trained and taught to facilitate better management of interruptions (Koh et al., 2011).…”