TOPLINE: 

Approximately 80% of anesthesiologists and perioperative nurses in the United States reported experiencing at least one head strike in the operating or procedural room in the past year, with placement of equipment being the key contributing factor. Only 4.8% of those experiencing head strikes filed safety reports.

METHODOLOGY:

• Researchers conducted a cross-sectional study to examine the frequency and features of head strikes, the practices for reporting them, and the potential strategies for preventing them in perioperative settings.
• They sent a survey containing 22 questions to 23,486 anesthesiologists and 10,684 perioperative nurses in the United States, with the only difference in the surveys being in the options for role group.
• Participants were asked about their experiences of head strikes in the operating or procedural room over the past year; the analyses covered frequency, sources, timings, and reporting practices and focused on those who reported experiencing head strikes.
• A total of 1549 anesthesiologists and 287 perioperative nurses participated, making the response rates 6.6% and 2.7%, respectively.

TAKEAWAY:

• Among anesthesiologists, 78.2% reported experiencing at least one head strike in the past year, with 15% experiencing more than five incidents; among perioperative nurses, 80.1% reported experiencing head strikes, with 17.4% experiencing more than five incidents.
• Monitors, light heads, and equipment mounted on booms were the most common sources of head strikes, as reported by 73.4%, 37.4%, and 33.4% of respondents who experienced a head-strike injury, respectively.
• Intraoperative head strikes were common, affecting 63.7% of anesthesiologists and 76.5% of nurses. Although head strikes rarely caused work absences (in 1.7% of respondents), six respondents said they took medical leaves of over 4 weeks as a result of the incident. Perioperative nurses were more likely to report work absences following a head strike than were anesthesiologists (relative risk, 5.70; P < .001).
• Only 4.8% of respondents who reported experiencing head strikes reported the incidents through safety systems, with barriers to reporting including lack of knowledge on how to file a report, time constraints, and perception of minor impact.
• Strategies suggested by participants to prevent head strikes included establishing and adhering to protocols for the timing of equipment placement (n = 31) and using padding to reduce the risk (n = 84); strategies involving padding included padding the edges of hanging equipment. Two anesthesiologists proposed creating a designated space for anesthesiologists.

IN PRACTICE:

"As colleagues, we can look out for each other in different role groups, especially when we notice multiple risk factors colliding — low ambient light, multiple cords and floor hazards, and a colleague focusing on a task,” the researchers wrote. “We can and should encourage each other to report and take head strikes and other injuries seriously. We should collaborate to designate and place equipment in safe locations out of paths of transit and dedicated anesthesia spaces. For more robust, systemic change to support our ability to provide excellent patient care, our fields can advocate for safer and smarter design of equipment and space.”

SOURCE:

The study was led by Anastasia P. Piersa, MD, MBA, of the Department of Anesthesiology at the Mass General Brigham in Boston. It was published online on September 16 in Anesthesiology.

LIMITATIONS: 

The low response rates in the study may have introduced selection bias, as clinicians affected by head strikes might have been more likely to respond to the survey. The reliance on self-reported data over the past year could lead to recall bias, as participants might forget minor incidents. The online survey format, while practical, may not provide as much qualitative data as compared with interviews or focus groups.

DISCLOSURES:

This study received support only from the institution and department. One author reported receiving research support from CRICO for work not related to this study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.