Top 4 Ways Nurses Can Overcome Communication Breakdowns in a Noisy OR

Operating rooms hum with activity, echoing the clang of metal instruments and the buzz of power tools. While essential to surgery, this noise can distract the team and challenge clear communication.

Louise Grant, PhD, MClinSci, RN, MACORN, MACN, understands this all too well. She noticed the excessive noise in the OR 20 years ago when she transferred from nursing in a quiet coronary care unit to intraoperative care. And she recalls coming home from a shift and shouting to her husband – even in a quiet house – because she was used to doing it in the OR all day.

Dr. Grant has focused on raising awareness among OR team members about how workplace noise can interfere with critical team communications, as supported by her PhD research.

Through her work, she’s identified evidence-based strategies to overcome noise-induced distractions in the OR. She plans to share these insights on overcoming noise and distraction during an education session at AORN’s upcoming annual conference in Boston, April 5-8.

Ahead of the session, Dr. Grant shared these top 4 evidence-based strategies periop professionals can use to ensure safe communication in the OR:

1. Call Out Someone’s Name Before Starting to Speak to Them

Addressing someone by name ensures you have their full attention before starting a conversation. To make this possible, teams are using creative methods to share names in the OR, such as listing them on a whiteboard or wearing hats labeled with names and roles.

2. Use Hand and Facial Gestures to Communicate

Gestures can be effective with or without verbal communication. For example, a simple request for more sponges can be gestured without speaking. Hand gestures can also reinforce what is being discussed.

3. Practice Closed-loop Communication

This technique, commonly used in police and military settings, involves the listener repeating back what they heard to confirm accuracy. It ensures the correct information was received (and also spoken). Closed-loop communication is essential during a crisis or trauma situation but also works well for communication in a noisy OR.

4. Walk to a Colleague Before Speaking to Them

This catches their attention and allows you to be heard without speaking as loudly. It also reduces noise in the OR. For example, a circulating nurse walking over to the anesthesia team catches their attention.

Pick up more strategies from Dr. Grant by attending her session "What Did You Say?" Communication Failures and Noise in Operating Room at AORN Global Surgical Conference & Expo in Boston, MA, April 5–8.