Wednesday, 5 August 2015

Is music in the operating theatre dangerous?

Roger Watson, Editor-in-Chief

Music is played during the majority of operations performed in operating theatres (OTs) and has been playing in OTs almost since it was possible to have portable music devices. Admittedly, some may nor seem that portable these days and with increasing portability has come increasing frequency of music being played and an increasing variety of the music being played.

Originally music in OTs was meant to benefit patients by creating a relaxing ambience as they were anaesthetised and, according to patients in at least one study, they like it (Stevens 1990).  According to another study, it does reduce pre-operative anxiety (Cooke et al. 2005).  However, there is an assumption that such music is soothing, suitable to a broad taste in music and not having any unexpected adverse consequences.

Apart from the fact that one person's music can be another person's torture, what if music is not soothing, but loud and intrusive?  Can this have adverse consequences?  According to a recent study conducted at Imperial College London by Weldon et al. (2015) titled: Music and communication in the operating theatre and published in JAN, it can. Music can be so loud and intrusive that it hampers staff communication and good communication in  the OT is essential for patient safety both in terms of speed and accuracy of information exchange, requests and instructions.

In the study by Weldon et al. video recordings were made of operations with and without music and the speed - in terms of how often things had to be repeated - of communication was observed and recorded.  In the presence of music the speed of communication was decreased as people had to ask for information to be repeated.

OTs are already noisy environments and the noise levels exceed recommended safety limits.  The addition of music which, by virtue of the already high background noise has to be played loud, adds to the problem.  According to the authors: 'This study has identified serious patient safety issues that cannot be ignored.  Regardless of whether music can increase surgeons' concentration and mask extraneous noise, anything that might impair team communication might place patients' safety in jeopardy.'  As a recommendation they say: 'We recommend that nurses join the discussion and debate around this topic that is currently heavily represented by the views of surgeons.'

You can listen to this as a podcast.


Weldon. S-M., Korkiakangas. T., Bezemer, J. and Kneebone. R. (2015) Music and communication in the operating theatreJournal of Advanced Nursing, doi: 10.1111/jan.12744

Cooke, M., Chaboyer, W., Schluter, P. and Hiratos, M. (2005), The effect of music on preoperative anxiety in day surgery. Journal of Advanced Nursing, 52: 47–55.

Stevens, K. (1990), Patients' perceptions of music during surgery. Journal of Advanced Nursing, 15: 1045–1051. 

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