Abstract
Objective Orthopedic surgeries generate high noise levels that exceed recommended thresholds, thereby posing risks to surgical safety. Nurses play a critical role in instrument preparation and intraoperative monitoring. However, evidence of noise-induced cognitive impairment in this population remains limited. This study evaluated the effects of intraoperative noise exposure on nurses' reaction times and error rates during orthopedic procedures. METHODS: This retrospective study analyzed data from 200 orthopedic surgeries conducted in a tertiary hospital over 12 months. Noise levels in the operating rooms (ORs) were recorded using calibrated noise meters. Nurses' cognitive performance was assessed by measuring reaction time and error rate. Baseline demographic and clinical data, such as age, experience, gender, and surgery type, were included. Correlation analysis and multivariate regression were performed to assess the relationships among noise levels, reaction time, and error rates. RESULTS: The average noise level in the ORs was 89.73 ± 11.52 dB (range: 60-120 dB). Noise levels showed significant positive correlations with reaction delays (r = 0.54, P < 0.01) and error rates (r = 0.68, P < 0.01). Nurses exposed to noise levels exceeding 100 dB had an average reaction time of 274.82 ± 45.80 ms, compared with 261.48 ± 47.63 ms in quieter environments. Error rates increased sharply beyond 100 dB, with a mean of 0.91% ± 0.05%, compared with 0.61% ± 0.04% at lower noise levels. Multivariate logistic regression analysis confirmed noise as an independent risk factor for delayed reaction time and increased error rate. CONCLUSION: Noise exposure during orthopedic surgeries significantly affects nurses' information processing, increasing reaction times and error rates. Noise mitigation strategies are essential to enhance OR safety and nursing performance.