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Interventions for reducing wrong-site surgery and invasive clinical procedures.

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Area of Science:

  • Healthcare Quality Improvement
  • Patient Safety Research
  • Surgical Error Prevention

Background:

  • Wrong-site surgery is a rare but severe clinical error requiring effective interventions.
  • Risk factors for wrong-site surgery are complex and varied.
  • Organizational and professional strategies can minimize wrong-site surgery incidence.

Purpose of the Study:

  • To evaluate the effectiveness of organizational and professional interventions in reducing wrong-site surgery.
  • The evaluation includes various procedures like regional blocks, dental, obstetric, and emergency surgeries.
  • The study also covers wrong-side, wrong-procedure, and wrong-patient surgical errors.

Main Methods:

  • Searched multiple electronic databases (Cochrane EPOC, CENTRAL, MEDLINE, EMBASE, CINAHL) up to January 2014.
  • Included randomized controlled trials (RCTs), non-randomized controlled trials, controlled before-after studies (CBAs), and interrupted time-series (ITS) studies.
  • Two review authors independently assessed study quality and extracted data using standardized forms.

Main Results:

  • An initial ITS study showed a significant reduction in wrong-site tooth extractions following an educational intervention.
  • An updated study found a significant difference in wrong-site surgery (WSS) incidence in neurosurgery before and after Universal Protocol implementation.
  • While the updated study showed a statistically significant change in slope, the change in level was not significant.

Conclusions:

  • The review suggests educational interventions may reduce wrong-site tooth extractions.
  • The additional neurosurgery study indicated a downward trend in WSS prior to the Universal Protocol.
  • The overall effectiveness of interventions remains unclear due to limited data from two small, low-quality studies in specific populations.