Accidentally falling instruments during orthopaedic surgery: time to wake up!

Area of Science:

• Orthopedic Surgery
• Surgical Safety
• Medical Device Management

Background:

• Accidental falls of surgical instruments and implants pose a significant challenge in operating rooms worldwide.
• These incidents can lead to increased operating time, resource utilization, and potentially compromise surgical results.

Purpose of the Study:

• To statistically evaluate the incidence and primary causes of accidental instrument and implant falls during orthopedic procedures.
• To identify personnel responsible for falls and quantify the impact on surgical workflow.

Main Methods:

• A prospective observational study conducted over 18 months.
• 120 major orthopedic surgeries were randomly selected for observation.
• Data collected included the frequency of falls, nature of the falling item, personnel involved, and resulting delays.

Main Results:

• A total of 39 falls were recorded across 120 surgeries, with 61.5% occurring during emergency (trauma) procedures.
• The operating surgeon was responsible for 66.7% of falls, followed by the assisting surgeon (17.9%) and scrub nurse (7.7%).
• An average delay of 7.6 minutes was observed following each instrument fall.

Conclusions:

• Instrument falls in the operating theatre are a prevalent issue with substantial implications for surgical efficiency and outcomes.
• The operating surgeon is the most frequent cause of these falls, highlighting a need for targeted interventions.
• Implementing specialized instrument handling training, similar to existing theatre nurse protocols, could mitigate these occurrences.