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Sources of error when tracking irrigation fluids during hysteroscopic procedures.
Summary
Circulating nurses struggle to accurately estimate fluid balance during hysteroscopy. Significant errors in tracking irrigation fluid input and output can accumulate, impacting patient safety.
Area of Science:
- Gynecologic Surgery
- Patient Safety
- Surgical Nursing
Background:
- Accurate fluid management is critical in hysteroscopic procedures.
- Estimating fluid volumes intraoperatively presents challenges for nursing staff.
Purpose of the Study:
- To assess the accuracy of circulating nurses' estimations of irrigating fluid input and output during hysteroscopic procedures.
- To identify potential sources of error in fluid volume tracking in the operating room.
Main Methods:
- Simulated intraoperative measurements were conducted in an operating room setting.
- Circulating nurses estimated fluid volumes under conditions mimicking hysteroscopic ablative or resection procedures.
Main Results:
- Irrigation bags showed minor overfilling (average 2.8%).
- Estimates of fluid in partially emptied bags, kick buckets, and on the floor had substantial errors (up to 50%, 39%, and 67% respectively).
- Suction canister accuracy depended on calibration, with actual volumes differing significantly from rated capacity.
Conclusions:
- Accurate tracking of irrigation fluid during hysteroscopy is challenging due to estimation errors.
- Fluid loss on the operating room floor contributes significantly to volume discrepancies.
- Automated fluid-tracking systems with fluid capture devices are recommended to improve accuracy and patient safety.