Cognitive Distractions During Sonographic Procedures: Reducing Noise-Based and Light-Based Interruptions in Hospital Rooms

Sonographers experience a high cognitive load in hospital-based care. High ambient noise and frequent noise-based interruptions include knocking on the room door, questions from others in the room or through communication technology, alarms, alerts from personal devices, and carts and people passing in the hallway. In addition, other providers turning on the overhead light is distracting for exams that need to be conducted in reduced lighting conditions. This article suggests strategies to improve working conditions for sonographers conducting exams on a patient in the hospital room. Our strategies emerge from human factors methods and principles, which derive from communication principles and theory. These strategies are organized by reducing noise-based and light-based interruptions in the hospital room and hallway, primarily through changes to the built environment and communication technology settings and reducing the use of speech during cognitively challenging time periods through training. Most of the strategies are low-cost and can be implemented within the current built environment and communication technology infrastructure. We anticipate that these strategies could enhance patient outcomes, increase patient satisfaction, improve sonographers’ job satisfaction, protect provider health, and increase procedural efficiency.

1. Barker, LM, Nussbaum, MA. Fatigue, performance and the work environment: a survey of registered nurses. J Adv Nurs. 2011;67(6):1370–1382. doi:
10.1111/j.1365-2648.2010.05597.x.
Google Scholar | Crossref | Medline | ISI2. Nagavarapu, S, Lavender, SA, Marras, WS. Spine loading during the application and removal of lifting slings: the effects of patient weight, bed height and work method. Ergonomics. 2017;60(5):636–648. doi:10.1080/00140139.2016.1211750.
Google Scholar | Crossref | Medline3. Patterson, ES, Rayo, MF, Edworthy, JR, Moffatt-Bruce, SD. Applying human factors engineering to address the telemetry alarm problem in a large medical center. Human Factors. 2021. doi:10.1177/00187208211018883
Google Scholar | SAGE Journals4. Welch, SJ, Cheung, DS, Apker, J, Patterson, ES. Strategies for improving communication in the emergency department: mediums and messages in a noisy environment. Jt Comm J Qual Patient Saf. 2013;39(6):279–286. doi:10.1016/S1553-7250(13)39039-4.
Google Scholar | Crossref | Medline5. Stramler, JH . The Dictionary for Human Factors: Ergonomics. Routledge; 2018. doi:10.1201/9780203736890.
Google Scholar | Crossref6. Woods, DD . Coping with complexity: the psychology of human behaviour in complex systems, in Goodstein, LP, Andersen, B, Olsen, SE (eds): In Tasks, Errors, and Mental Models. New York, NY, Elsevier, 1988, pp 128–148.
Google Scholar7. Monaghan, M, Mahmoud, AAA, Holmes, C. Too noisy to sleep safely?—an observational study of noise levels and distractions during critical phases of pediatric anesthesia. Paediatr Anaesth. 2020(12):1402–1408. doi:10.1111/pan.14036.
Google Scholar | Crossref8. Pope, D . Decibel levels and noise generators on four medical/surgical nursing units. J Clin Nurs. 2010;19(17–18):2463–2470. doi:10.1111/j.1365-2702.2010.03263.x.
Google Scholar | Crossref | Medline9. Grissinger, M . Sidetracks on the safety express. Interruptions lead to errors and unfinished . . . wait, what was I doing? Pharm Therapeut. 2015;40(3):145–146.
Google Scholar10. Bani Younis, M, Hayajneh, F, Alshraideh, JA. Effect of noise and light levels on sleep of intensive care unit patients. Nurs Crit Care. 2021;26(2):73–78. doi:10.1111/nicc.12490.
Google Scholar | Crossref | Medline11. Albala, L, Bober, T, Hale, G, et al. Effect on nurse and patient experience: overnight use of blue-depleted illumination. BMJ Open Qual. 2019;8(3). doi:10.1136/bmjoq-2019-000692.
Google Scholar | Crossref | Medline12. Vincent, CA, Wears, RL. Communication in the emergency department: separating the signal from the noise. Med J Aust. 2002;176(9):409-410. doi:10.5694/j.1326-5377.2002.tb04478.x.
Google Scholar | Crossref | Medline

Comments (0)

No login
gif