Evaluating the effect of distractions in the operating room on clinical decision-making and patient safety

March 23, 2016

Source: Surgical Endoscopy [Epub ahead of print]

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Date of publication: February 2016

Publication type:  Journal article

In a nutshell:  Answering telephone calls and pagers is common distraction in the operating room. This study sought to evaluate the impact of distractions on patient care by (1) assessing the accuracy and safety of responses to clinical questions posed to a surgeon while operating and (2) determining whether pager distractions affect simulation-based surgical performance.

The study found that distractions in the operating room may have a profound impact on patient safety on the wards. While multitasking in a simulated setting, the majority of residents made at least one unsafe clinical decision. Pager distractions also hindered surgical residents’ ability to complete a simulated laparoscopic task in the allotted time without affecting other variables of surgical performance.

Length of publication:  6 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library


Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population

February 24, 2016

Source:  International Journal for Quality in Healthcare [Epub ahead of print]

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Date of publication: January 2016

Publication type:  Journal article

In a nutshell:  Efforts to improve patient safety are challenged by the lack of universally agreed upon terms. The International Classification for Patient Safety (ICPS) was developed by the World Health Organization for this purpose. This study aimed to test the applicability of the ICPS to a surgical population.

The authors conclude that this study demonstrates that a framework for patient safety can be applied to facilitate the organisation and analysis of surgical safety data. Several unique aspects of surgical care require consideration, and by using a standardised framework for describing concepts, research findings can be compared and disseminated across surgical specialties. The codebook is intended for use as a framework for other specialties and institutions.

Length of publication:  Unspecified

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library


Enhancing surgical safety using digital multimedia technology

November 25, 2015

Source: American Journal of Surgery [Epub ahead of print]

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Date of publication: October 2015

Publication type:  Journal article

In a nutshell: The purpose of this study was to examine whether incorporating digital and video multimedia components improved surgical time-out performance of a surgical safety checklist. A prospective pilot study was designed for implementation of a multimedia time-out, including a patient video. The conclusion of the study was that the multimedia time-out allows improved participation by the surgical team and is preferred to a standard time-out process.

Length of Publication: Unspecified

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library


Quality improvement in surgery combining lean improvement methods with teamwork training: a controlled before-after study

October 28, 2015

Source:  PLOS ONE 10/9 e0138490

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Date of publication: September 2015

Publication type:  Journal article

In a nutshell:  This study investigated the effectiveness of combining teamwork training and lean process improvement, two distinct approaches to improving surgical safety. A controlled interrupted time series study was conducted in a specialist UK Orthopaedic hospital incorporating a plastic surgery team (which received the intervention) and an Orthopaedic theatre team acting as a control. The study found that combining teamwork training and systems improvement enhanced both technical and non-technical operating team process measures, and were associated with a trend to better safety outcome measures in a controlled study comparison. The authors suggest that approaches which address both system and culture dimensions of safety may prove valuable in reducing risks to patients.

Length of Publication:  1 web page


New safety standards published for invasive procedures

September 30, 2015

Source:  NHS England

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Date of publicationSeptember 2015

Publication type:  News item

In a nutshell: The National Safety Standards for Invasive Procedures (NatSSIPs) aim to reduce the number of patient safety incidents related to invasive procedures in which surgical Never Events could occur. The new standards set out broad principles of safe practice and advise healthcare professionals on how they can implement best practice. The standards will support NHS providers to work with staff to develop and maintain their own, more detailed, local standards and encourage the sharing of best practice between organisations. The NatSSIPs build on the existing WHO Surgical Checklist and promote the effective performance of the Five Steps to Safer Surgery guidance.

Length of Publication:  1 web page


Escalation of care in surgery: a systematic risk assessment to prevent avoidable harm in hospitalized patients

June 24, 2015

Source:  Annals of Surgery 261/5 pp. 831-8

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Date of publicationMay 2015

Publication type:  Journal article

In a nutshell: This review aims to systematically risk assess and analyse the escalation of care process in surgery to identify problems and provide recommendations for intervention. It discusses Healthcare-Failure-Mode-Effects-Analysis (HFMEA), a methodology adapted from safety-critical industries, which allows for hazardous process failures to be prospectively identified and solutions to be recommended. Failures in the escalation process amenable to intervention were systematically identified in this review. The authors say that the mapping of the escalation process will allow tailored interventions to enhance surgical training and patient safety.

Length of Publication:  8 pages


Effectiveness of interventions to improve patient handover in surgery: A systematic review

June 24, 2015

Source:  Surgery 158/1 pp. 85-95

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Date of publication:  May 2015

Publication type:  Journal article

In a nutshell:  The authors of this study examined interventions to improve handover in surgery. The interventions included paper and computerised checklists, forms and standardised operating protocols for handover. All studies found some degree of improvement in handover processes. Checklists or forms can be used to improve information transfer during surgery handovers. The process of implementation is poorly described in the literature however.

Length of Publication:  11 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library