scholarly journals Patient Safety in Spine Surgery: Regarding the Wrong-Site Surgery

2013 ◽  
Vol 7 (1) ◽  
pp. 63 ◽  
Author(s):  
Seung-Hwan Lee ◽  
Ji-Sup Kim ◽  
Yoo-Chul Jeong ◽  
Dae-Kyung Kwak ◽  
Ja-Hae Chun ◽  
...  
Keyword(s):  
Patient Safety ◽  
Spine Surgery ◽  
Wrong Site Surgery ◽  
Wrong Site

scholarly journals Patient safety awareness among 309 surgeons in Enugu, Nigeria: a cross-sectional survey

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Arinze Duke George Nwosu ◽  
Fidelis Anayo Onyekwulu ◽  
Elias Chikee Aniwada
Keyword(s):  
Patient Safety ◽  
Public Health Problem ◽  
Professional Status ◽  
Major Public Health Problem ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Safety Issues ◽  
Wrong Site Surgery ◽  
Safety Awareness ◽  
Wrong Site

Abstract Background Adverse healthcare events are major public health problem with the heaviest burden in the low and middle-income countries. Patient safety awareness among healthcare professionals is known to impact this outcome; thus we set out to appraise the patient safety awareness among surgeons in Enugu, Nigeria. Methods A multi-institutional cross-sectional survey was carried out among surgeons in Enugu, Nigeria and data obtained were analyzed using the statistical package for scientific solutions (SPSS) version 20 software. Results A total of 309 surgeons were surveyed. Majority of the surgeons (51.9%) had poor perception of patient safety issues. One hundred and twenty respondents (38.8%) have awareness of any institutional protocol for preventing wrong-site surgery while only 35 respondents (11.3%) regularly practiced an institutional protocol for preventing wrong-site surgery. The professional status of the surgeons and years in service showed significant association with perception of patient safety issues. Conclusion The patient safety awareness and practice among the surgeons in Enugu, Nigeria is apparently low and this was found to be influenced by the professional status and years in service of the surgeon.

scholarly journals The use of collaboration to implement evidence-based safe practices

2013 ◽  
Vol 2 (3) ◽  
pp. 26 ◽  
Author(s):  
John R. Clarke
Keyword(s):  
Patient Safety ◽  
Best Practices ◽  
Operating Room ◽  
Medical Error ◽  
Near Miss ◽  
Evidence Based ◽  
Wrong Site Surgery ◽  
Eastern Pennsylvania ◽  
One Year ◽  
Wrong Site

The Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with institutions to identify local barriers to and incentives for adopting best practices and redesigning the delivery system to make desired behaviour easy and undesirable behaviour more difficult. Collaborations, where institutions can learn from the experiences of others, have show decreases in harmful events. The Pennsylvania Program to Prevent Wrong-Site Surgery is used as an example. Two collaborations to prevent wrong-site surgery have been completed, one with 30 institutions in eastern Pennsylvania and one with 19 in western Pennsylvania. The first collaboration achieved a 73% decrease in the rolling average of wrong-site events over 18 months. The second collaboration experienced no wrong-site operating room procedures over more than one year.

scholarly journals Litigation costs of wrong-site surgery and other non-technical errors in orthopaedic operating theatres

2015 ◽  
Vol 97 (8) ◽  
pp. 592-597 ◽  
Author(s):  
WD Harrison ◽  
B Narayan ◽  
AW Newton ◽  
JV Banks ◽  
G Cheung
Keyword(s):  
Patient Safety ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Improve Patient Safety ◽  
World Health ◽  
Wrong Site Surgery ◽  
Technical Errors ◽  
Operating Theatres ◽  
Wrong Site

Introduction This study reviews the litigation costs of avoidable errors in orthopaedic operating theatres (OOTs) in England and Wales from 1995 to 2010 using the National Health Service Litigation Authority Database. Materials and methods Litigation specifically against non-technical errors (NTEs) in OOTs and issues regarding obtaining adequate consent was identified and analysed for the year of incident, compensation fee, cost of legal defence, and likelihood of compensation. Results There were 550 claims relating to consent and NTEs in OOTs. Negligence was related to consent (n=126), wrong-site surgery (104), injuries in the OOT (54), foreign body left in situ (54), diathermy and skin-preparation burns (54), operator error (40), incorrect equipment (25), medication errors (15) and tourniquet injuries (10). Mean cost per claim was £40,322. Cumulative cost for all cases was £20 million. Wrong-site surgery was error that elicited the most successful litigation (89% of cases). Litigation relating to implantation of an incorrect prosthesis (eg right-sided prosthesis in a left knee) cost £2.9 million. Prevalence of litigation against NTEs has declined since 2007. Conclusions Improved patient-safety strategies such as the World Health Organization Surgical Checklist may be responsible for the recent reduction in prevalence of litigation for NTEs. However, addition of a specific feature in orthopaedic surgery, an ‘implant time-out’ could translate into a cost benefit for National Health Service hospital trusts and improve patient safety.

Assessment of the implementation of a national patient safety alert to reduce wrong site surgery

2008 ◽  
Vol 17 (6) ◽  
pp. 409-415 ◽  
Author(s):  
P Rhodes ◽  
S J Giles ◽  
G A Cook ◽  
A Grange ◽  
R Hayton ◽  
...  
Keyword(s):  
Patient Safety ◽  
Wrong Site Surgery ◽  
Safety Alert ◽  
National Patient ◽  
Wrong Site

A Proactive Risk Assessment Methodology to Enhance Patient Safety: Reducing Wrong Site Surgery as a Preventable Medical Error

2020 ◽  
Vol 64 (1) ◽  
pp. 664-668
Author(s):  
Maryam Tabibzadeh ◽  
Gelareh Jahangiri
Keyword(s):  
Risk Assessment ◽  
Patient Safety ◽  
Integrated System ◽  
Wrong Site Surgery ◽  
Healthcare Settings ◽  
Enhance Patient Safety ◽  
Sentinel Events ◽  
Area Of Concern ◽  
Risk Assessment Methodology ◽  
Wrong Site

Patient safety has been a major area of concern over the last decades in the healthcare industry. The number of preventable medical errors in hospitals has been noticeably high. These errors are more likely to occur in intensive care units including Operating Rooms (ORs). Wrong site surgery is one of the critical sentinel events that occur in healthcare settings. This paper fills an important gap by proposing an integrated, system-oriented methodology for proactive risk assessment of operations in ORs, to specifically analyze the wrong site surgery issue, through the identification and monitoring of appropriate Leading Safety Indicators (LSIs) to evaluate the safety of those operations and generate warning/predicting signals for potential failures. These LSIs are identified across the layers of an introduced framework, which is built on the foundation of the Human-Organization-Technology (HOT) model originally developed by Meshkati (1992). This multi-layered framework captures the contributing causes of wrong site surgery.

scholarly journals Medical malpractice in spine surgery: a review

2020 ◽  
Vol 49 (5) ◽  
pp. E16
Author(s):  
Zachary A. Medress ◽  
Michael C. Jin ◽  
Austin Feng ◽  
Kunal Varshneya ◽  
Anand Veeravagu
Keyword(s):  
Spinal Cord ◽  
Spine Surgery ◽  
Medical Malpractice ◽  
Ethical Considerations ◽  
Wrong Site Surgery ◽  
Cord Injury ◽  
Substantial Risk ◽  
History Of ◽  
Early Phases ◽  
Wrong Site

Medical malpractice is an important but often underappreciated topic within neurosurgery, particularly for surgeons in the early phases of practice. The practice of spinal neurosurgery involves substantial risk for litigation, as both the natural history of the conditions being treated and the operations being performed almost always carry the risk of permanent damage to the spinal cord or nerve roots, a cardiopulmonary event, death, or other dire outcomes. In this review, the authors discuss important topics related to medical malpractice in spine surgery, including tort reform, trends and frequency of litigation claims in spine surgery, wrong-level and wrong-site surgery, catastrophic outcomes including spinal cord injury and death, and ethical considerations.

Strategies to avoid wrong-site surgery during spinal procedures

2011 ◽  
Vol 31 (4) ◽  
pp. E5 ◽  
Author(s):  
Wesley Hsu ◽  
Ryan M. Kretzer ◽  
Michael J. Dorsi ◽  
Ziya L. Gokaslan
Keyword(s):  
Patient Care ◽  
Spine Surgery ◽  
Rare Occurrence ◽  
Wrong Site Surgery ◽  
Wrong Side ◽  
Wrong Site

Wrong-site surgery (WSS) is a rare occurrence that can have devastating consequences for patient care. There are several factors inherent to spine surgery that increase the risk of WSS compared with other types of surgery. Not only can a surgeon potentially operate on the wrong side of the spine or the wrong level, but there are unique issues related to spinal localization that can be challenging for even the most experienced clinicians. The following review discusses important issues that can help prevent WSS during spinal procedures.

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