Increasing Anesthesia Provider Knowledge on Noise and Cognitive Overload in the Operating Room

Abstract

Purpose. This quality improvement project aims to increase the knowledge of Certified Registered Nurse Anesthesiologists, Nurse Anesthesiology Residents, and Physician Anesthesiologists regarding noise levels, the effects of noise on cognitive overload in the operating room during the anesthetic phases of induction and emergence, and noise reduction strategies, utilizing a targeted educational presentation. Background. Noise in the operating room setting has increased steadily over the past few decades, while simultaneously, there have been documented increases of patient safety issues when healthcare providers are in a state of cognitive overload (McNeer et al., 2017, Gui et al. 2021). After a needs based assessment was completed at a local hospital it was found that there was a lack education on the effects of noise in the operating room and the impact noise has on cumulative cognitive load, the signs of cognitive overload, and the potential impact of noise and cognitive overload on patient safety. Methods. All Certified Registered Nurse Anesthesiologists (CRNAs), Nurse Anesthesia Residents, and Physician Anesthesiologists at a local Colton, California, hospital were invited to participate. The intervention consisted of a live educational PowerPoint presentation at a weekly staff meeting. Participants were sent a recruitment email one week prior to the presentation containing the date and time. Data was collected using a post-pre survey utilizing Qualtrics to analyze the level of learning after the presentation. Results. There was a statistically significant improvement across all aims of the project. Following an in-person educational presentation, there were increases in knowledge on operating room noise, patient- and provider-related consequences of noise, and noise mitigation strategies. Findings showed that respondents had minimal knowledge before the presentation and became highly knowledgeable regarding all key areas of interest related to noise with p-values: < 0.001, demonstrating statically significant results. These significant knowledge changes suggest that this intervention meaningfully addressed an area of knowledge deficit among anesthesia providers. Conclusions. Key findings were statistically and clinically significant and support the use of an educational presentation to enhance anesthesia provider knowledge on the effects of noise and cognitive overload on the anesthesia provider and patient safety in the operating room.