Safer Surgery part 45. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 414 Safer Surgery multi-task - . to shift attentional focus from the primary task to one or more secondary tasks. Psychological research suggests that such shifts come at a cost as performance at the primary task deteriorates . Altmann and Trafton 2007 Monsell 2003 Trafton and Monk 2008 and that different people are affected to different degrees by such demands to multi-task . Ishizaka et al. 2001 . This means that some surgeons will fare better than others in coping with distracting events in the OR - an individual difference that should be assessed systematically. A final consideration is the interaction of expertise and individual differences with the level of disruptiveness in the OR. Simply put junior surgeons might be able to cope with an equipment failure when everything else is going smoothly in a procedure. However if a technical problem appears jointly with an equipment failure in an OR team that does not communicate information very well the same situation will become more stressful and the potential for impaired performance will increase. Multilayered disruptions to surgical work are likely to have an effect on performance significantly more pronounced than the effect of individual distracting events. Question 3 Can the OR be Designed in Such a Way that Unnecessary Disruptions are Minimized The preliminary links between distractions stress and performance are important from a patient safety perspective. Demirtas et al. 2004 p. 929 suggested that the aroused emotional state of surgeons during an operation make them more prone to make mistakes as a result of physical and mental fatigue and strain and concluded that surgeons may have a legal responsibility to consider the negative impact of factors such as stressors distractions and mental strain on their performance. Distractions can greatly add to stressors that are inherent in surgery and thus significantly increase stress by increasing demand upon the individual see Figure . It follows .
