The extended surgical time-out: does it improve quality and prevent wrong-site surgery?
نویسنده
چکیده
PURPOSE To review the initial results of implementing an extended surgical time-out (STO) in pediatric surgery. METHODS Starting in January 2006, all members of our surgical team implemented and used an extended STO, confirming the patient's identity, technical and anesthetic details, administered and available medications, and need for blood products and special equipment. To avoid disrupting work flow, the STO was initially after anesthesia induction. Starting in October 2007, the STO was done before anesthesia induction. Initial results, elapsed time to incision, and surgical team surveys were reviewed before and after implementing the preinduction STO. RESULTS The elapsed time to incision was similar for elective and urgent operations before and after implementing the preinduction STO. All antibiotics were administered and confirmed during the STO. Four significant equipment findings were detected, altering the planned procedure (two before and two after implementing the preinduction STO). Operating room staff felt more confident and prepared for the operations because communication was improved. One near-miss occurred during the postinduction STO. One wrong-site operation occurred despite the preinduction STO, because of inadequate marking. Root-cause analysis demonstrated that this was due to a systems error. CONCLUSIONS Using the extended STO before anesthesia induction improved communication among the surgical team members and did not disrupt work flow. An extended STO may also have broader value, such as confirming timely antibiotic administration or meeting other quality measures. The extended STO did not eliminate wrong-site surgery. However, implementation of the STO placed the responsibility for wrong-site surgery with the whole team and system, rather than with the individual surgeon.
منابع مشابه
Can We Improve Patient Safety?
Despite greater awareness of patient safety issues especially in the operating room and the widespread implementation of surgical time out World Health Organization (WHO), errors, especially wrong site surgery, continue. Most such errors are due to lapses in communication where decision makers fail to consult or confirm operative findings but worryingly where parental concerns over the planned ...
متن کاملEffectiveness of Surgical Safety Checklists in Improving Patient Safety.
Wrong-site surgery is all too common. Despite more than a decade of campaigns by major organizations to prevent these events, there are still reports of such mistakes. This article reviews the recent literature on surgical safety checklists and other tools designed to prevent wrong-site surgery and improve patient safety in the operating room. Emphasis is placed on how well institutions comply ...
متن کاملA protocol for the reduction of surgical errors.
M edical errors make headline news. The headlines will always emphasise the human suffering associated with medical error, but the prevention of such errors comes as the result of detailed analysis of their circumstances. One area of particular concern to surgeons is wrong site/wrong side surgery. Although its occurrence is rare, it is potentially avoidable. A notable recent case in the UK was ...
متن کاملCompliance with a time-out procedure intended to prevent wrong surgery in hospitals: results of a national patient safety programme in the Netherlands
OBJECTIVE To prevent wrong surgery, the WHO 'Safe Surgery Checklist' was introduced in 2008. The checklist comprises a time-out procedure (TOP): the final step before the start of the surgical procedure where the patient, surgical procedure and side/site are reviewed by the surgical team. The aim of this study is to evaluate the extent to which hospitals carry out the TOP before anaesthesia in ...
متن کاملThe Effect of Applying Topical Vancomycin Powder on Prevention of Surgical Site Infection in Patients Undergoing Spinal Surgery Using Implants
Background and Aim: Surgical Site Infection (SSI) is one of the most important complications after spine surgeries. Different methods have been proposed to prevent this type of infection. The present study was performed to evaluate the effect of applying topical vancomycin powder on prevention of SSI in patients undergoing spinal surgery using implants in Al-Zahra Hospital, Isfahan, Iran from F...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The Permanente journal
دوره 14 1 شماره
صفحات -
تاریخ انتشار 2010