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Patient safety in the operating room at a governmental hospital
Hanan A Sayed1, Mouchira Zayed, Noha M El Qareh
1aDepartments of Public Health, Anaesthesia and General Surgery, Theodor Bilharz Research Institute bDepartment of Public Health, Faculty of Medicine, Cairo University, Cairo, Egypt.
Background:
Patient safety is a fundamental principle of healthcare; it is a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical errors that often lead to adverse healthcare events.
Objectives:
The aim of this study is to aid any hospital in attaining better quality of patient care in the operating room (OR) by achieving patient safety according to the WHO safety guidelines. Specific objectives include the assessment of patient safety status in OR, the identification of hazards, and the assessment of risks that jeopardize this safety.
Materials And Methods:
This is a descriptive observational study carried out in three ORs of a governmental hospital. The study was carried out from December 2008 through April 2009. A total of 100 patients undergoing general surgical and urological surgical procedures were selected. The data collection tools included the WHO surgical safety checklist, nonstructured interviews, patient records, anesthesia checklist, and the risk assessment matrix.
Results:
According to the WHO safety checklist, patients' safety was checked during three stages. During the 'sign in' stage, only 3% of all the patients had the operation site marked for surgery and an incident of a single wrong side surgery was recorded. There was a clear lack of communication between doctors and patients. During the 'time out' stage, 80% of surgeries lacked organized discussion among surgical team members for anticipated critical events. Prophylactic antibiotics were administered to 59% of patients undergoing surgeries. The 'sign out' stage was properly carried out in 100% of the procedures. Risk assessment in the 'sign in' stage showed six of 11 procedures leading to a major risk to patients. Also, in the 'time out' stage, three of eight procedures had a major risk.
Conclusion And Recommendations:
To reach an optimal level of patient safety in the OR, it is recommended that the checklist should be implemented as part of the daily surgical routine. Identification of the hazards to which patients could be exposed and assessment of risks must be the ultimate goal in any OR.
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