Course taster

Safer surgery 2

Wrong site surgery incidents continue to raise our awareness to ensure our patients receive the correct operation. Horrifying stories, such as a male patient needing a lesion removed from the end of his genitals incorrectly having a vasectomy, are not what the patient wants.

A female patient due to have an arthroscopy on her left knee incorrectly had her good right knee operated on.

A UK tabloid reported in 2014:

Mistakes by NHS staff are killing 12,500 every year: and they operate on wrong body part once a week, reveals Hunt

Borland (2014)

Hunt commented:

Twice a week we leave a foreign object like a swab inside someone's body. Last spring, in one of our major hospitals with a good reputation, we removed someone's fallopian tube instead of her appendix.

Borland (2014)

Read more here: Mistakes by NHS staff are killing 12,500 every year: And they operate on wrong body part once a week, reveals Hunt

These stories are shocking to hear and have a negative impact on public confidence in the healthcare system. Therefore, the WHO's (2009) 'safe surgery saves lives' approach aims to improve surgical safety and to reduce surgical deaths. The Surgical Safety Checklist contains a simple set of safety standards that can be applied in any hospital operating department in any country. Read more: WHO Surgical Safety Checklist

As part of the checklist, the availability of key equipment is required to confirm the patient's oxygen saturation level, the patient's blood pressure and the positioning of an endotracheal tube. Yet, in developing countries, such equipment might not exist (Bharati et al. 2014). Haynes et al.'s (2009) research study of patents demonstrated the connection between the use of a surgical safety checklist and reduced morbidity and mortality. They introduced the WHO Surgical Safety Checklist in eight hospitals in different locations. In their dataset, they saw postoperative complications reduce by 36%, with fewer patient deaths. This reduction was attributed to the implementation and continuous use of the checklist.

The Royal Australasian College of Surgeons (2015) reported that during the period January 2009 to December 2015, 36,047 deaths were associated with surgical care. Causes of surgical deaths included poor management of fluid balance, pulmonary embolism, trauma and sepsis. The case studies showed where a middle-aged patient presenting with headaches should have been intubated, ventilated and sedated for transfer from a surgical location to another hospital setting. The clinical lessons are critical to preventing further surgical deaths or mortality when transferring patients to another location.