Safe Surgery Saves Lives Initiative Research Articles

Adherence to the objectives of the Safe Surgery Saves Lives Initiative: perspective of nurses

ABSTRACTObjective:to measure the adherence to the objectives of the Safe Surgery Saves Lives Initiative in surgical centers from the perspective of nurses. Method:cross-sectional study, developed through an online survey via the Google Forms® platform. The study participants were 220 nurses from surgical centers in different regions of Brazil. The data were collected through a socio-professional characterization form and a questionnaire in which the participants indicated their level of agreement in relation to the fulfillment of the objectives of the Safe Surgery Saves Lives Initiative. Data analysis was performed using descriptive statistics. Results:objective 1, The team will operate on the correct patient at the correct site, presented the highest levels of total agreement (n = 144; 65.5%) and partial agreement (n = 52; 23.6%). Objective 10, Hospitals and the public health systems will establish routine surveillance of surgical capacity, volume and results, obtained the lowest percentages of total (n = 69, 31.4%) and partial agreement (n = 81, 36.8%). Conclusion:adherence to the objectives of the Initiative is adequate, but there are weaknesses, especially in relation to the prevention of never events.

Surgical Safety Checklist Popularity among the surgeons?A survey

Background: W.H.O has introduced a surgical safety checklist as part of its Safe Surgery Saves Lives initiative. The checklist’s purpose was to reduce surgical complications that resulted from inadequate safety practices and promote greater communication among surgery teams. It is made necessary to use the surgical safety checklist in the operation theatres across the world but is it really used in the actual practical setup?Material & Methods: With that idea in mind we had conducted a study to know about the awareness and practical use of surgical safety checklist among surgeons attending Haryana Chapter of Association of Surgeons in India Conference (HASICON) 2014 in there surgical practice. Printed performa with a set of questions was given to the delegates and the result was analysed.Result: Only 57% of the study group had heard about the safety checklist and only 32% of them are using it in their surgical practice.Conclusion: There is an urgent need to spread awareness about the safety checklist and one way of achieving it is by demonstration papers in conferences across the world.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.521-524

University of California, Los Angeles, surgical time-out process: evolution, challenges, and future perspective

Since the development of the WHO Safe Surgery Saves Lives initiative and Surgical Safety Checklist, numerous hospitals across the globe have adopted the use of a surgical checklist. The UCLA Health System developed its first extended Surgical Safety Checklist in 2008. Authors of the present paper describe how the time-out checklist used before skin incision was implemented and how it progressed to its current form. Compliance with the most recent version of the checklist has been closely monitored via documentation and observance audits. In addition, the surgical team's appreciation of the current time-out has been assessed. Cultural, practice, and human resource challenges are discussed, as are potential future avenues for innovations in the emerging field of the surgical checklist in neurosurgery.

The anaesthetist and the World Health Organization Surgical Safety Checklist

Correctly implemented, the World Health Organization Surgical Safety Checklist (WHO SSCL) may be a breakthrough in surgical patient care. The WHO SSCL was developed as part of the WHO’s World Alliance for Patient Safety Safe Surgery Saves Lives initiative. The project was led by Atul Gawande, a Boston-based endocrine surgeon, and developed over several months through discussions and meetings with surgeons, anaesthetists, operating nurses, and technical experts from around the world. It aims to reinforce accepted safety practices, and foster better communication and teamwork in theatres, thereby improving patient safety.

Patients Have a Right to Safe Surgery

The remarkable rise in medical tourism has brought into question the foundation of the patient–doctor relationship and is endangering many who seek low-cost surgery. We see travel agencies brokering surgery for their clients with surgeons they have never met. The patients have no assurance that their surgeon is properly trained or qualified to perform the procedure they will undergo, and all too often, little attention is paid to postsurgical care. The complication rates for surgeries performed under these circumstances are alarming. An article in the August issue of Aesthetic Surgery Journal entitled Complications from International Surgery Tourism referred to a recent U.S. study showing an increase in postsurgical complication rates among patients returning from surgery overseas. Statistics presented 3 years ago by International Society of Aesthetic Plastic Surgery (ISAPS) member, Professor James Frame (UK), during the Medical Tourism Association meeting in San Francisco reported a 20% complication rate in patients returning to the UK after surgery abroad. In quite a few cases, the complications were sufficiently serious that the patients had to go directly to a hospital for care on their return. The Patient Safety Diamond devised by then ISAPS President, Dr. Foad Nahai (US), and presented at the ISAPS Congress in 2010 bases the concept of safe surgery on four factors: the patient, the surgeon, the procedure, and the facility. The patient should be a good candidate for the requested surgery. The surgeon must be properly trained and credentialed. The procedure should be appropriate for the patient. The surgical facility should be an accredited and proven safe venue with properly trained staff and emergency preparedness. When the World Health Organization (WHO) introduced the Safe Surgery Saves Lives initiative promoting their Surgical Safety Checklist (www.who.int/patientsafety/safesurgery/en/), ISAPS was one of the initial endorsing organizations at the launch of this program in Washington, DC in June of 2008. A recent study published in the New England Journal of Medicine showed that use of the 19-question checklist reduced surgical complications by more than one third and surgical deaths by almost half in the test hospitals compared with control hospitals. This simple form is used much as a pilot uses a checklist before taking a plane onto a runway for takeoff. In 2006, Dr. Joao C. Sampaio Goes (Brazil), president of ISAPS at the time, developed key guidelines for those patients who decide to travel for their surgery. These guidelines are posted on the ISAPS website (www.isaps.org ). Several other organizations have since adapted these for their websites. Dr. Jan Poell (Switzerland), the current President of ISAPS, explains the need for this information: ‘‘Consumers around the world have looked to ISAPS for over 40 years for the most accurate and reliable information about qualified plastic surgeons and advice about procedures. ISAPS provides a worldwide standard for consumers to reference when traveling for aesthetic plastic surgery.’’ Many patients have the misconception that anyone with an MD can safely perform any surgical procedure. Legislation around the world is changing to reflect a growing concern that patients are undergoing surgical treatment by incompetent and untrained individuals—sometimes not even physicians. Several countries including Italy, Russia, Mexico, Colombia, the Czech Republic, and Canada are leading the way with new regulations controlling who can perform what specific procedures on which patients and in what facility. This is also the case in Denmark, a front C. B. Foss (&) International Society of Aesthetic Plastic Surgery, 45 Lyme Road, Suite 304, Hanover, NH 03755, USA e-mail: isaps@conmx.net

Patient safety in anaesthesia

Patient safety in anaesthesia

Introducing the WHO's Safe Surgery Saves Lives initiative to ophthalmic nurses involved in ORBIS' training programmes

Aim: To monitor and improve patient safety systems within partner peri-operative nursing settings within developing regions of the world through the implementation the WHO's Safe Surgery Saves Lives initiative. Method: Prior to implementation of the Safe Surgery Saves Lives initiative ORBIS observed and assessed existing safety systems and the use of patient indicators within partner hospitals in 2010. Thereafter ORBIS provided training and conducted preliminary assessment of new skills within each hospital. Results: ORBIS' programmes had a significant impact on introducing, informing and instructing nurses within ORBIS' partner hospitals around the world of the importance of safe surgery checking within the peri-operative ophthalmic department. Conclusion: This initiative demonstrates the need for training and the implementation of safe site surgery checking systems within peri-operative ophthalmic departments within developing region partner hospitals around the world, and it highlights the ongoing need to continue such training.

Atul Gawande—making surgery safer worldwide

Atul Gawande—making surgery safer worldwide

Healthcare associated infection: novel strategies and antimicrobial implants to prevent surgical site infection

This report is based on a Hygienist Panel Meeting held at St Anne's Manor, Wokingham on 24-25 June 2009. The panel agreed that greater use should be made of antiseptics to reduce reliance on antibiotics with their associated risk of antibiotic resistance. When choosing an antiseptic for clinical use, the Biocompatibility Index, which considers both the microbiocidal activity and any cytotoxic effects of an antiseptic agent, was considered to be a useful tool. The need for longer and more proactive post-discharge surveillance of surgical patients was also agreed to be a priority, especially given the current growth of day-case surgery. The introduction of surgical safety checklists, such as the World Health Organization's Safe Surgery Saves Lives initiative, is a useful contribution to improving safety and prevention of SSIs and should be used universally. Considering sutures as 'implants', with a hard or non-shedding surface to which micro-organisms can form biofilm and cause surgical site infections, was felt to be a useful concept.

Global operating theatre distribution and pulse oximetry supply: an estimation from reported data

Surgery is an essential part of health care, but resources to ensure the availability of surgical services are often inadequate. We estimated the global distribution of operating theatres and quantified the availability of pulse oximetry, which is an essential monitoring device during surgery and a potential measure of operating theatre resources. We calculated ratios of the number of operating theatres to hospital beds in seven geographical regions worldwide on the basis of profiles from 769 hospitals in 92 countries that participated in WHO's safe surgery saves lives initiative. We used hospital bed figures from 190 WHO member states to estimate the number of operating theatres per 100,000 people in 21 subregions throughout the world. To estimate availability of pulse oximetry, we sent surveys to anaesthesia providers in 72 countries selected to ensure a geographically and demographically diverse sample. A predictive regression model was used to estimate the pulse oximetry need for countries that did not provide data. The estimated number of operating theatres ranged from 1·0 (95% CI 0·9-1·2) per 100,000 people in west sub-Saharan Africa to 25·1 (20·9-30·1) per 100,000 in eastern Europe. High-income subregions all averaged more than 14 per 100,000 people, whereas all low-income subregions, representing 2·2 billion people, had fewer than two theatres per 100,000. Pulse oximetry data from 54 countries suggested that around 77,700 (63,195-95,533) theatres worldwide (19·2% [15·2-23·9]) were not equipped with pulse oximeters. Improvements in public-health strategies and monitoring are needed to reduce disparities for more than 2 billion people without adequate access to surgical care. WHO.

Extending the WHO ‘Safe Surgery Saves Lives’ project through Global Oximetry

Extending the WHO ‘Safe Surgery Saves Lives’ project through Global Oximetry

Standardised metrics for global surgical surveillance

Public health surveillance relies on standardised metrics to evaluate disease burden and health system performance. Such metrics have not been developed for surgical services despite increasing volume, substantial cost, and high rates of death and disability associated with surgery. The Safe Surgery Saves Lives initiative of WHO's Patient Safety Programme has developed standardised public health metrics for surgical care that are applicable worldwide. We assembled an international panel of experts to develop and define metrics for measuring the magnitude and effect of surgical care in a population, while taking into account economic feasibility and practicability. This panel recommended six measures for assessing surgical services at a national level: number of operating rooms, number of operations, number of accredited surgeons, number of accredited anaesthesia professionals, day-of-surgery death ratio, and postoperative in-hospital death ratio. We assessed the feasibility of gathering such statistics at eight diverse hospitals in eight countries and incorporated them into the WHO Guidelines for Safe Surgery, in which methods for data collection, analysis, and reporting are outlined.