emergency and critical care
Situation awareness during crisis in the OR
The operating room is a complex environment and knowledge and improvement of situation awareness can increase the performance in this domain , leading to better patient outcomes
Diana Zamudio Penko PhD
Daniel Arnal Velasco MD Department of Anaesthesia and Critical Care , The Alcorcon Foundation University Hospital , Spain
Situation awareness ( SA ) can be defined as ‘ the perception of elements of the environment within a volume of time and space , the comprehension of their meaning and the projection of their status in the near future ’. 1 In simple terms , it is knowing what is going on around you by extracting information from the environment and then integrating that information to create a notion of the situation and anticipate future events . Therefore , SA is important for effective decision-making , performance and teamwork . 2 Understanding the meaning of SA and how to improve it in a complex work environment , such as the operating room ( OR ), is essential for patient safety .
Individual SA According to the definition , SA is subdivided into
24 HHE 2018 | hospitalhealthcare . com three levels : perception ( level I ), comprehension ( level II ) and projection ( level III ). 2 The first level comprises the identification of the key elements that assess the ongoing situation ; in the OR , the perception of the patient ’ s state is provided by the patient ( for example , through verbal communication or appearance ), monitors , patient charts , communication within the team , anaesthesia machines , respirators , and the surgical field . 3 The second level comprises the comprehension and integration of multiple pieces of information and the determination of their relevance to the situation to form a coherent mental picture . Finally , the highest level entails the ability to forecast the future development of the patient ’ s state and determine the best way to proceed .