•Reduced surgical equipment noise should be
conveyed as a critical design factor to surgical
instrument and device manufacturers.
The risks of distraction in the OR and the tools to
overcome distraction should be incorporated in
training programs for surgeons and for perioperative personnel. The importance of designing health
care facilities to reduce transmitted noise into the
OR should be emphasized when facilities are being
conceived and maintained. Noise levels should be
considered when surgical and anesthetic devices
and instrumentation are selected. ♦
The ACS offers this statement for consideration by surgeons, their hospitals, and health care organizations.
This statement is provided as general guidance. It does
not constitute a standard of care and is not intended
to replace the professional judgment of the surgeon or
health care administrator. The statement may be reviewed and modified as necessary to conform with the
laws of the applicable jurisdiction, the circumstances
of the individual hospital and health care organization, and requirements of other allied health care organizations.
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2. Magrabi F, Li SY, Dunn AG, et al. Challenges in measuring the
impact of interruption on patient safety and workflow outcomes.
Methods Inf Med. 2011; 50( 5):447-453.
3. Sumwalt R. Sterile cockpit rules: FAR 121.542/FAR 135.100.
National Aeronautics and Space Administration. ASRS Directline.
Available at: asrs.arc.nasa.gov/publications/directline/dl4_
sterile.htm#anchor524636. Accessed August 15, 2016.
4. U.S. Department of Transportation. Federal Aviation
Administration. Cockpit distractions. April 26, 2010. Available at:
Accessed August 15, 2016.
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intraoperative pathway: A new operating room model for team-based practice. J Am Coll Surg. 2008;207( 6):865-873.
6. Wyatt RM. The Joint Commission. The alarming world. The
Leadership Blog. July 17, 2013. Available at: www.jointcommission.
org/jc_physician_blog/the_alarming_world/. Accessed August
7. The Joint Commission. The R3 report: Requirement, rational,
reference: Alarm system safety. December 11, 2013. Available at:
www.jointcommission.org/r3_report_issue5/. Accessed August
8. Agency for Healthcare Research and Quality. Alarm safety
resource site. Available at: innovations.ahrq.gov/qualitytools/
alarm-safety-resource-site. Accessed August 15, 2016.
9. The Joint Commission. Sound the alarm: Managing physiologic
monitoring systems. The Joint Commission Perspectives on Patient
Safety. December 2011. Available at: www.jointcommission.org/
assets/1/6/perspectives_alarm.pdf. Accessed August 15, 2016.
The importance of designing health care facilities to reduce
transmitted noise into the OR should be emphasized when facilities
are being conceived and maintained.