AST Guideline - Use of Mobile Information Technology in the Operating Room

2 However, technology comes with challenges and in this instance a key challenge is monitoring the appropriate use of MIT in the OR (and other critical care areas of the HDO). The problem has been referred to as “ distracted doctoring ” in which healthcare personnel (HCP) are focused on the screen and not the patient including conducting personal business and accessing Internet sites during surgical procedures, in the ICU, and other critical care units. 2,14 For example, medical students and residents are under increasing pressure to access MIT such as iPads and smartphones that are being provided to them by the school; the pressure originates from the drive in modern medicine that patient care is data driven and immediate access to the latest information is a priority. The American Association of Nurse Anesthetists summed up the issue in their position statement by stating “non- essential distractions, especially those associated with the use of mobile information technology (e.g., smartphones, tablets, personal digital assistants [PDAs]), the Internet, and the data accessed through these tools, may lead to significant patient safety lapses.” 15 OR personnel preoccupied by a mobile device including texting, accessing social networks, reading or using mobile devices on a general non-clinical basis is distracted from the primary task and therefore, considered a patient safety issue. 15,16,17 In response, HDOs have begun establishing policies and procedures that limit the use of MIT in critical care settings, and some medical schools have started reminding students and residents to focus on the patient and use the mobile device at the appropriate time. 2 As Dr. Peter W. Carmel, President of the American Medical Association has said, technology “offers great potential in health care”, but the doctors’ first priority should be with the patient. 2 This should also be the priority of CSTs while providing perioperative care to the surgical patient, and not allow mobile devices to come between them and the patient. Evidence-based Research and Key Terms The research of articles, letters, nonrandomized trials, and randomized prospective studies was conducted using the Cochrane Database of Systematic Reviews and MEDLINE®, the U.S. National Library of Medicine® database of indexed citations and abstracts to medical and healthcare journal articles. The key terms used for the research of the Guidelines include: auto-location technology; cross-contamination; distracted doctoring; electromagnetic interference; mobile information technology; non-critical care areas; protected health information; social media. Key terms used in the Guidelines are italicized and included in the glossary. Guideline I Mobile devices must be properly cleaned and disinfected prior to being brought into the surgery department or other critical care unit, e.g. preoperative holding or PACU. 1. Mobile devices are a source of cross-contamination and can contribute to microbial contamination in the OR. A. In the U.S., 1.7 million patients are affected by healthcare-associated infections (HAI). 18 Multiple studies have confirmed that over 90% of HCPs’ cell phones tested positive for bacteria, including methicillin- resistant Staphylococcus aureus (MRSA) and other microbes that can cause HAIs. 19,21,22,23,24 B. Jeske et al. reported that even after 40 anesthesia care providers used hand sanitizer, the majority of mobile devices were found to have pathogens. 24