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

5 D. Smartphones are limited by the small screen that may not properly and clearly display information that can be a patient safety risk. For example an electronic health record (EHR) system that is designed for use on a laptop or desktop computer may be displayed poorly on the small screen of the smartphone. Additionally, the user may need to scroll through the information possibly missing vital patient information that is hidden from view on the smaller screen. 35 E. OR personnel should avoid sending job-related messages to other HDO departments or clinicians by text messaging. 31 1) Many clinicians who use smartphones to send job-related messages do so by text messages. 8 Texting has limitations that make it inappropriate for communications related to patient care. In 2011, the Joint Commission issued the following statement: This method provides no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered into the medical record. 36 Guideline III OR personnel should turn off mobile devices in the presence of critical care or life support medical equipment to prevent interference with the functioning of the equipment. 1. Controversy exists as to the extent of mobile devices electromagnetic interference (EMI) with medical equipment. 8,37 There is concern that the newer generation of mobile devices that can access the Internet as well as receive and send information may increase the incidences of EMI. 38 Regardless of the improved magnetic shielding of critical care and life support equipment, there is a possibility that EMI can cause equipment to either display an incorrect value, or alter the baseline movements or information causing the alarm to activate. A. Studies have reported contradictory results regarding EMI due to the use of mobile devices. 1) A 2005 study reported a 1.2% incidence of interference out of 500 tests and concluded there was clinically significant interference. 39 2) Incidences of medical devices, such as infusion pumps and ventilators, affected by EMI have been reported as well as anesthesia care providers reporting interference with anesthesia equipment by cell phones. 8,40 3) A study reported a controlled laboratory test of 76 types of OR and ICU equipment that 15% of the equipment was affected by mobile device signals. 37 2. The effect and degree of EMI depends on the type of mobile device and power output, susceptibility of the medical device to EMI, and distance between the mobile and medical device. 8,37 A. The higher the output power of a mobile device the higher the risk of EMI. 8 A Wi-Fi connection has much lower power than a cellular connection, thus less likely to cause EMI. 8 Wi-Fi connections are consistently safely used in HDOs, including near medical equipment. OR personnel should configure