Taxonomy of communications in the operating room

Abstract

US hospitals are facing critical problems of nurse shortage. One report predicts that there will be a shortage of 260,000 registered nurses by 2025 in the USA, and it was found out that patient mortality risk is 6% higher in hospitals understaffed with nurses compared to units fully staffed. One possible solution to cope with such nurse shortage problem is to develop robotic scrub nurses that can collaborate with surgeons. Some robotic systems have been specifically developed to handle instruments to the surgeon in the operating room. These robotic systems work under the assumption that verbal and gesture communication are the most common modalities. This study shows that expert surgical staff do not use specific gestures to communicate and rely only in two modalities: predictions performed by the assistant and verbal commands. From a group of 68 instruments delivered, during three cardiothoracic surgeries, 47 corresponded to successful predictions and 23 to verbal commands. Only one wrong prediction was observed but no specific gesture.