Evaluation of a Noise Reduction and Information Management System on Noise, Stress, Communication and User Acceptance of Crews in the Operating Room and the Medical Laboratory
Kumulative Dissertation
Datum der mündl. Prüfung:2023-05-05
Erschienen:2023-05-16
Betreuer:Prof. Dr. Margarete Boos
Gutachter:Prof. Dr. Margarete Boos
Gutachter:Prof. Dr. York Hagmayer
Dateien
Name:Dissertation_Lehrke.pdf
Size:4.40Mb
Format:PDF
Zusammenfassung
Englisch
The theoretical background includes the working definitions, theories, and models. It will be shown that noise levels exceed recommendations by the World Health Organisation and that the consequences of noise are detrimental to health and performance. One potential explanation for the negative consequences of noise is that noise functions as a stressor. Stress as a concept is introduced and psychological models are presented as they explain how the SOS may reduce stress. Since communication is another affected variable, this construct and different communication functions in the OT are explained. Studies showed that noise and stress can impair communication. Other potential solutions for the noise situation in those working settings are addressing the issue suboptimally, which is why the SOS is evaluated through an investigation of the derived hypotheses, detailed in the three articles. In the first article the SOS in the OT is examined. In total, 81 individuals filled out questionnaires before and after each of 21 heart surgeries and 32 robot-assisted radical prostatectomies included in the study. Results revealed a SOS effect, as the group using the system showed a significant stress and exhaustion reduction. In the second article the SOS during heart surgeries is investigated. The communication of 46 crew members during 22 heart surgeries was recorded, transcribed, segmented, and coded. The results showed no noise differences between treatment conditions in the room. The crew using the system spoke less, which might favour a lower microbial load relevant for the rate of surgical site infections (SSI). The SSI rate was descriptively lower in the experimental group. Additionally, the case-relevant communication (CRC) proportion was not higher in general in the experimental group but in the critical phase 4. The SOS also did not lower the case-irrelevant-communication (CIC) proportion in the last phase of surgery. Nevertheless, the found pattern may have beneficial effects in terms of reducing distractive effects while promoting performance and team climate. In the third article the SOS in the medical laboratory is assessed. Results showed that the SOS did not reduce noise in the room, but that it successfully reduced noise for the workers using the system. The SOS also reduced stress on all subjective measures, but not on the physiological parameter cortisol. The acceptance of the system was rated as mostly high by the participants. Finally, the evaluation revealed that the system reduces noise for the working crews, but the noise level in the room is not affected. As the users are the primary object of the evaluation it can be concluded that the SOS is a noise reduction tool (H1). The hypothesised stress reduction was achieved by the SOS (H2). It must be mentioned that all subjective measures reacted beneficially, whereas the two physiological stress measurements did not. More research is needed to examine whether a suboptimal measurement approach was causative for not revealing the expected small effect or if the SOS has no effect on the physiological parameters. The communication was not enhanced in the hypothesised manner (H3). Nevertheless, the SOS shows an effect on communication which may be worth investigating. The system led to less communication which might have a reducing effect on SSIs, and it enabled technical high-quality communication via its technical properties. The found higher CRC proportion in the critical phase and the constant level of CIC may have beneficial effects on performance and team climate. As the stress reducing effect was evident, a new hypothesis was developed, which stated that the SOS might reduce stress via its newly found communication pattern. The acceptance of the SOS was high across studies (H4). In the end, the SOS did defend its claim to be a noise reduction and communication management tool, with stress reducing effects and high acceptance.
Keywords: SOTOS, noise reduction, technology, operating room, operating theatre, surgery, surgical staff, stress, exhaustion, communication, noise, medical laboratory