Do Clinicians Need Their Own DWI Rule?

The National Transportation Safety Board made front-page news recently with its suggestion to create a national ban on all non-emergency use of cell phones while driving a vehicle--including hands-free calls.

Their rationale is simple. Talking, emailing, or texting on any mobile device distracts drivers from their top priority--driving safely. What's all this have to do with healthcare workers?

A recent report in the New York Times cited several disturbing examples of nurses, doctors, and technicians in critical patient care situations using tablets, computers, and smartphones to check Facebook, shop on E-Bay, or text friends.

Similarly, a survey in the professional journal Perfusion said, "The use of a cellphone during the performance of cardiopulmonary bypass (CPB) was reported by 55.6% of perfusionists. Sending text messages while performing CPB was acknowledged by 49.2%." This despite the fact that the majority of perfusionists taking the same survey admitted that using a cellphone while operating a heart lung machine is unsafe.

Even more disturbing was the report from a medical malpractice lawyer, cited in the New York Times article, describing the case of a patient who was partially paralyzed after surgery performed by a neurosurgeon. The physician was wearing a headset and talking on his cellphone during the operation.

Distracted doctoring and nursing can interfere with good patient care even in less critical situations. I've heard more than one patient complain that providers have their noses buried in a computer during their visit. Of course, the age of EHRs requires clinicians to input lots of data, and those e-records can improve patient care in countless ways. But patients still need eye contact, and they miss it when it's not there.

At this year's InformationWeek Healthcare IT Leadership Forum, Charles Lockwood, MD, chief of obgyn at Yale New Haven Hospital at the time of the conference, said that at his facility, they put computers on rolling carts so that it's easier for clinicians make eye contact with patients while entering data. Another option is replacing laptops with tablets. It's easier to engage patients in an eye-to-eye conversation while holding an iPad in your hand then it is sitting behind a computer.

It's hard to know for certain whether the distractions caused by cellphone conversations are dangerous enough to warrant a ban even on hands-free devices. The evidence is not exactly iron-clad. But texting in the OR, or checking your Facebook page during cardiopulmonary bypass? That's a no-brainer.

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