This article written by (2006) asserts OR briefings and wrong site surgery which assumes a catastrophic event for a patient, caregiver and institution, the article explains evaluated impact of operating room briefings on coordination of care and risk for wrong-site surgery. The study design was appropriate in testing research validity and paradigms as case study design imposes a useful tool in research to the time out policy and that the inclusion of Safety Attitudes Questionnaire (SAQ) to operating room staff is one reliable basis upon achieving a definite goal within hospitals, the items are enough to sanctioned effectiveness as there dealt to overall coordination and awareness of the surgical site. The analysis and interpretations have ranged certain responses although the tool for comparison was sort of complicated to apply but still goof percentage were achieved as the OR staff responses was reported. The article explains outcomes from such response rates of 85% from 306 of 360 respondents and 75% from 16 of 154 respondents. ( 2006) The research served right for the research vigor they were composed of surgeons (34.9%), anesthesiologists (14.0%), and nurses (44.4%). Agreeing to the indication that, surgery and anesthesia worked together into team as well as increased awareness of the surgical site and side being operated understanding from the article that OR briefings reduced risk for wrong-site surgery and improve perceived collaboration among OR personnel. ( 2006 , 2007 )
The core awareness provided by the article connects to OR briefing as one effective safety initiative designed to reduce wrong-site surgery and have useful implications in physician and nurse training. Thus, incorporating the OR briefing into residency training for surgery and anesthesiology residents, nursing training, and medical student training may prove beneficial in improving care coordination and reducing the incidence of wrong-site surgery. In addition, briefings help improve the teamwork climate in operating rooms by promoting consistent and structured communication, proactive planning for potential problems, and interdisciplinary collaboration between physicians and nurses in surgery and anesthesiology.
This particular article focuses on reports made by linking to wrong site surgery cases from where a total of 150 reported cases were identified. The organization of case reports was the core basis for the standing of this article written by and . These proponents was strong in there arguments as supported by observations and research studies as application of standard measures were known into percentage rankings in lieu to orthopedic surgery situation. Thus, the article mentions a particular program of great usage referring to “sign your Site” program as the program urged surgeons to talk to their patients prior to the surgery in order to confirm procedures to be done, which body part to touch and other factors to do. There was the use of survey methodology which serve as a good tool for research support and it was then noted that 60 percent of the surgeons were marking the surgical site and the article assumes that 1 out of 4 orthopedic surgeons will perform at least one wrong site surgery. It is then imperative to avoid the factors leading to wrong site surgery and there was a clear research finding like, the putting of outcomes into percentile ranks of the survey conducted. The strong and weak points can be seen into the limited flow of information and data based on the actual accumulation of the research approach. Truly, the possible prevention can be in knowing marking of surgical site, as well as creating a checklist wherein a possible time out is a must protocol upon ensuring that all procedures are set into correct place before operation will start officially.
The article is good in presenting the public and the readers that patient safety and security is a vital mission and vision by the OR team at all times following strict standards and regulations as approved by the health authorities of the hospital and health institutions in general. The article is emphasizing the contribution of for the issue of reducing risks in health care and that it is just right to present factual information to the public when it comes to miss outs in OR even though it does not occur everyday but still it adheres to an alarming reality that bites people in majority. The authors is good in presenting ideas linking to patient’s role and that awareness strikes deep when understanding to the process are achieved and that trusts of patient should be preserved in whatever way the hospital can, thanks to JCAHO for imposing stop moment in hospitals and that time out policy have to be followed under all means upon doing the right thing into the situation. Indeed, verification comes into the picture as the article merits the importance of realizing goals and applying objectives in avoiding medical errors from every area of health milieu.
It can be that the article incurs a detailed discussion regarding wrong site surgery as a devastating problem affecting the patient, surgeon, anesthesiologists as well as nurses involved case to case basis. Agreeing to what the article noted that, ‘operating on the incorrect site is nontraditional patient safety issue but is of consideration because of what role anesthesia caregivers have in verifying correct and intended surgical procedure as about to take place. The article functions then as an advisory created and written for orthopedic surgeons and there incurs that concepts presented are worth the consideration of anesthesiologists involved. The article talks about executive methods of eliminating wrong site surgery such as for instance, surgeons initials are placed on the operative site as can’t be overlooked and if in manner be clearly incorrect if transferred to another body part upon surgery as well as patient’s records are a must have and be available in the operating area. Thus, Code of Ethics have to be included and if possible be reviewed accordingly as the article points out the useful means of ethical standards in surgery as the surgeons must be truthful in all circumstances. There talks about actions which emphasizes an ideal view of strategies in discovering of wrong site surgery, the article is an effective material to get involved with imperative institutions upon thinking of better recommendations on the issues known such as the American Academy of Orthopedic Surgeons believes in unified effort in surgeons, health providers and hospitals in initiating preoperative regulations to effectively eliminate wrong cases of surgery.
2006
The article is about hospital patient transformation adhering to time out policy, as the article focuses on the policy by which there assures that the highest levels of patient safety, both the nursing staff and security staff will positively identify patients who are delivered to or transported from all nursing units as the correct patient. In the article the role of nurses plays a critical part as the nurse will verify the patient identity using two forms of patient identification, will document the time of the patient’s arrival in takes down patient medical record and the emphasis of acknowledgement by the physician of the process. The article incorporated three step search strategy as utilized, step one have identified initial words from Medline that will be used to construct database into comprehensive search strategy one good search engine adheres to OVID information. The article discusses facility guidelines ensuring patient care and safety is maintained by verifying the operative procedure and the appropriate surgical site. There were actions will be taken to verify the correct site, correct procedure and correct person. The inclusion of protocol was applicable to the operative as well as invasive procedures that expose patients to harm. The article expresses sort of narrative method from where, one team will perform a pre-procedure “Time Out” to verbally confirm the correct person, procedure, side, site, patient position and immediate availability of correct implantable devices with the entire surgical team. The “Time Out was then completed even when procedure site marking does not take place. The one good learning found in the article can be that, a practitioner is of no exempt from the site-marking requirement when he or she is in continuous attendance with the patient and requirement for “time out” applies very well. There certain reports of wrong-sided procedures being done despite the continued presence of the person performing the procedure from time to decision to completion of the procedure, for instances when procedure is performed without assistance, there advise to enlist an assistant to participate in the “time out”. There was known involvement of operative team as well as the use active communication for document process. From the article, it can be understood that time out policy is standardized procedure and documentation indicates the procedure was followed in its entirety without deviation.
Achieving the National Quality Forum's “Never Events”: Prevention of Wrong Site, Wrong Procedure, and Wrong Patient Operations
The article explains, “Never Events” of Wrong Site, Wrong Procedure and Wrong Patient Operations a study supported by Lippincott, Williams and Wilkins from the Annals of Surgery which is a review of surgical science. The article reviews evidence regarding methods to prevent wrong site operations and present framework that healthcare organizations can use to evaluate whether they have reduced the probability of wrong site, wrong procedure and wrong patient operations. Indeed, it can be true that few is known about effective policies to reduce never events and healthcare professional's knowledge or appropriate use of these policies to mitigate events. There was integration of PubMed and Google search which can be appropriate at the same time inappropriate due to the fact that Google search may impose unaccepted information and unacceptable by some Universities but the good point is there can be direct connection to PubMed as links to PubMed at some point is supported by URL. The article is detailed in explaining framework to evaluate safety and whether the policy is being used appropriately. The outcomes presented is useful to orthopedic surgeons as well as the OR team as such time out implemented is justifiable as possible. Believing at some point that, there was no scientific evidence is available to guide hospitals in evaluating whether they have an effective policy and whether staff know of the policy and appropriately use the policy to prevent never events.
Aside, it is possible to dig up more on behavioral interventions as the article presents only limited evidence of behavioral interventions in reducing surgical procedures and others and the outlining of measures id imperative to be of used by healthcare from evaluation determining adverse events in operations are reduced. The need to address concerns and issues as needed from where healthcare lacks a structured approach to evaluate whether safety efforts are reducing the risk of events that cannot be measured as rates. The survey used present strong locations noted were even if the instrument did not specify time period but instead asked whether surgeon had wrong-site surgery, sadly the authors could not estimate the incidence of wrong site operations, or the impact of the “Sign Your Site” campaign instituted by the AAOS. There was exceedingly limited empiric evidence regarding how to prevent wrong site operations. None of the studies reviewed presented quantitative evaluations of strategies to prevent wrong site operations. The contribution of JCAHO deserves better recognition in health care as the organization states the marking should be clearly observable after the surgical preparation and draping are completed. Site marking will likely have high impact in preventing wrong site operations because it is a well-defined behavior.
The cases then serves a focal point for OR in relation to time out policy and recommendations were of good substance and the operative plan should be and must be a success. The article is good in describing points of such technology information. The need to evaluate whether policies and procedures are being appropriately implemented is important. has received reports of wrong site operations occurring, even though a time-out was reportedly done. It could be that the time-out was done and the error could not be prevented, or the team went through the motions but did not execute an effective time-out. The compliance tool is what makes it effective as the authors are best in organizing vivid data in eyeing for OR briefings to better understand time out policy. Indeed, wrong site operations are preventable adverse events that often result in patient harm for one, study made by (2006) wherein malpractice claims alone found that two thirds of wrong site operations could have been prevented by a site-verification protocol.
Patient Identification Errors
This article from the Journal of Urology indicating patient identification error among prostate needle core biopsy specimens adhering for DNA time out readiness, as the article tells the readers that patient identification errors in surgical pathology often involve switches of prostate or breast needle core biopsy specimens among patients, The method which adheres to root cause analyses was in right inclusion of meta analysis for the study and there found that patient identification errors in surgical pathology result from slips and lapses of automatic human action that may occur at numerous steps during pre-laboratory, laboratory and post-laboratory work flow processes. The article serves as basis in linking information from where time out policy is of immediate concern in health care from which A DNA time-out are efficient upon confirming patient identification before radiation therapy or radical surgery, may eliminate patient identification errors among needle biopsies. Qualitative method is of relevance to the overall research vigor presented in article as the method focuses on discovering the underlying systems that set the stage for error and recognizing cases into the study deemed useful into the time out application, detailed case analysis is of great inclusion in research so as to prove that the policy can reduce wrong situations and matters that may happen into the actual care agreeing that certain DNA analysis suits the root cause execution, supporting that there can be contributing factor to the failure of root cause analysis such as the inability to retrieve empty specimen containers to determine whether labeling errors had occurred due to lack of storage space sufficient to retain large numbers of empty specimen containers for lengthy periods. The respondents of the study was in direct utilization for the methods applied as there can be complete source of information needed in judging several cases of patient identification errors, challenging prospective studies be required to evaluate the true incidence of switching errors in academic and community settings are beyond the scope of the current study. Formal evaluation of the cost-effectiveness of the DNA time-out may be performed after the true incidence of switching errors has been established.
Wrong-Side/Wrong-Site, Wrong-Procedure, and Wrong-Patient Adverse Events: Are They Preventable?
The article implies to wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events (WSPEs) which are devastating, unacceptable, and possibly outcomes in litigation, as the case occurs in common than realized, with little evidence that current prevention practice is adequate. The methods of several databases demonstrates that WSPEs occur with high numbers noted in orthopedic and dental surgery. The methods are ideally applied to prevent errors. The research is of strong impact of precise factors that contribute to the occurrence of WSPEs, as well as ways to reduce them. Discussing wrong-site, wrong-procedure and wrong-patient adverse events, are of real concern affecting health professionals of today and agreeing that prevention of WSPEs requires new and innovative technologies, reporting of case occurrence, and learning from successful safety initiatives meanwhile, reducing the shame associated with these events. The data indicate that current practices and guidelines for WSPE prevention are insufficient to prevent future events. The WSPE procedure are accurate as certain cases continue to occur outside the operating room (OR) in areas of health care. The studies found in the article are of enough amounts of diverse methodologies known. The retrospective chart review assumes effective domain made by universal protocol. The interpretations are of calculated frequencies and the rates are of median range. Although WSPEs are probably relatively rare events, we believe they are substantially underreported and totally preventable. The increased use of conscious sedation for surgical procedures in ambulatory and free-standing surgery centers will likely increase these numbers. Most states have little oversight of freestanding procedure facilities and thus have little means to record WSPEs in freestanding outpatient clinics. The reporting was informative and of acceptable substance as such reporting of WSPEs will occur when health care providers feel safe to report them as well as team approach having explicit knowledge and attitudes required of surgical team. Truly, best-practice evidence-based approach to prevent WSPEs should be applied to recommendations made before their dissemination and enforcement by regulatory agencies.
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