Surgeons under stress make more mistakes

Posted on under Today's research

If you’re going to have an operation be sure you have a super calm surgeon. Likewise, if you’re hiring for a job which needs precision and accuracy.

A new study reveals that during stressful moments in the operating room, surgeons make up to 66 percent more mistakes on patients. Using a technology that captured the electrical activity of a surgeon’s heart, researchers found that during intervals of short-term stress, which can be triggered by a negative thought or a loud noise in the operating room, surgeons are much more prone to make mistakes that can cause bleeding, torn tissue, or burns.

The results of the study, published in the British Journal of Surgery, could lead to the development of protocols aiming to reduce acute or short-term stress on surgeons working in the operating room. Medical errors cause between 250,000-440,000 deaths annually in the U.S., with a proportion of those mistakes occurring in operating rooms. Any change in common practice that reduces the number mistakes made by surgeons due to stress would also reduce the number deaths.

For the study the lead author persuaded a prominent surgeon to wear a Hexoskin Smart Shirt under his scrubs while he did surgeries. The shirt, designed to give athletes precise physiological data during workouts, measures the electrical impulses that trigger heartbeats. From this data, he derived heart-rate variability statistics to determine the surgeon’s stress levels.

He also made video recordings of the surgeon as he worked. Another researcher later reviewed the recordings and documented the surgeon’s mistakes using validated frameworks for assessing surgical performance. Both his stress levels and surgical errors were time stamped so that they could be correlated. This data yielded the somewhat alarming finding that the effect of short-term stress on surgical error is as high as a 66 percent increase.

“I was surprised by that, as well as by the number of distractions in the operating room,” said the lead author. “Many machines have alarms that go off periodically, equipment malfunctions, side conversations take place, people walk in and out of the OR—I could go on.”

So, what? The research is important because it shows in stark relief how stress—even momentary stress—can lead to mistakes that can be deadly. What was found in the OR could no doubt be replicated in the cockpit of a jetliner, on the road, or in any open plan office where little annoyances and stressors frequently occur. The findings show that it doesn’t take much.

 

By Dr Bob Murray