RT Journal Article SR Electronic T1 Distractions in the cardiac catheterisation laboratory: impact for cardiologists and patient safety JF Open Heart JO Open Heart FD British Cardiovascular Society SP e001260 DO 10.1136/openhrt-2020-001260 VO 7 IS 2 A1 Kalaivani Mahadevan A1 Elena Cowan A1 Navneet Kalsi A1 Helena Bolam A1 Richard Arnett A1 Alex Hobson A1 Kaushik Guha A1 Geraint Morton A1 Peter A Brennan A1 Paul R Kalra YR 2020 UL http://openheart.bmj.com/content/7/2/e001260.abstract AB Objective To understand human factors (HF) contributing to disturbances during invasive cardiac procedures, including frequency and nature of distractions, and assessment of operator workload.Methods Single centre prospective observational evaluation of 194 cardiac procedures in three adult cardiac catheterisation laboratories over 6 weeks. A proforma including frequency, nature, magnitude and level of procedural risk at the time of each distraction/interruption was completed for each case. The primary operator completed a National Aeronautical and Space Administration (NASA) task load questionnaire rating mental/physical effort, level of frustration, time-urgency, and overall effort and performance.Results 264 distractions occurred in 106 (55%) out of 194 procedures observed; 80% were not relevant to the case being undertaken; 14% were urgent including discussions of potential ST-elevation myocardial infarction requiring emergency angioplasty. In procedures where distractions were observed, frequency per case ranged from 1 to 16 (mean 2.5, SD ±2.2); 43 were documented during high-risk stages of the procedure. Operator rating of NASA task load parameters demonstrated higher levels of mental and physical workload and effort during cases in which distractions occurred.Conclusions In this first description of HF in adult cardiac catheter laboratories, we found that fewer than half of all procedures were completed without interruption/distraction. The majority were unnecessary and without relation to the case or list. We propose the introduction of a ‘sterile cockpit’ environment within catheter laboratories, as adapted from aviation and used in surgical operating theatres, to minimise non-emergent interruptions and disturbances, to improve operator conditions and overall patient safety.