Surgical Safety in Operation Theatre

1. MEDICAL SURGICAL
NURSING
TOPIC : SURGICAL SAFETY
Asha Kiran V
AK
1

2. PATIENT RELATED HAZARDS
AK 2

3. PATIENT RELATED HAZARDS
AK 3

4. SURGICAL SAFETY
AK 4
It is the safety measures and
practices taken to be
effective in preventing
adverse events during intra
and post operative period

5. EVENTS
AK 5
1. ADVERSE EVENTS:
An incident which result in harm to the patient.
2. NEAR MISS:
An incident which could resulted in unwanted
harm but did not.
3. NO-HARM EVENTS:
An incident that occur and reach to the patient
but result in no injury.

6. ADVERSE EVENTS DURING SURGERY
AK 6
1.Wrong site surgery
2.Wrong patient surgery
3.Retained instruments and swabs
4.Wrong drug administration
5.Surgical Site Infection
6.Potential accidents R/T diathermy and
other electro medical equipments.
7.Nerve injuries

7. OBJECTIVES OF SURGICAL SAFETY
AK 7
1.To operate on the correct patient at the
correct site.
2. To use methods known to prevent harm
from administration of anesthetics,
while protecting the patient from pain.
3. To recognize and effectively prepare for
life threatening loss of airway or
respiratory function

8. OBJECTIVES OF SURGICAL SAFETY
AK 8
4. To recognize and effectively prepare for risk of
high blood loss.
5. To avoid inducing an allergic or adverse drug
reaction for which the patient is known to be at
significant risk.
6. To consistently use methods known to
minimize the risk for surgical site infection.

9. OBJECTIVES OF SURGICAL SAFETY
AK 9
7. To prevent inadvertent retention of
instruments and sponges in surgical wounds.
8. To secure and accurately identify all surgical
specimens.
9. To effectively communicate and exchange
critical information for the safe conduct of the
operation.

10. Causes of adverse events
AK 10
• Co-morbidities
• Differing response to treatment
• Poor nutritional status.
• Long duration of immobility
Patient oriented
• Inadequate patient assessment
• Error in performance of an
operation and test.
• Inadequate monitoring or follow-up
• Deficient training or experience
• Fatigue, overwork or time
pressure.
• . Personal or psychological factor
HEALTH CARE
PROFESSIONALS

11. Causes of adverse events
AK 11
• Poor communication between
healthcare provider.
• Inadequate staffing level
• Lack of coordination at
handover
• Drug similarities.
• . Equipment failure
ADMINISTRA
- TIVE

12. AK 12
PREVENTION

13. SURGICAL SAFETY - components
AK 13
1. Consent of the patient/ relative in writing
2. Proper identification of patient, name wrist band
3. Proper identification mark of parts to be operated
4. Pre- anesthetic check-up
5. Anesthetic Safety
6. Ensure no foreign body left inside
7. Safety measures from ward to OT & coming back
(Safety check list)
8. Prevention of surgical wound infections
9. Following Surgical Safety Check list by WHO.

14. SURGICAL SAFETY MEASURES
AK 14
1)Efficient pre assessment that
identifies risk patients
2) Using patient identity bands
on admission

15. SURGICAL SAFETY MEASURES
AK 15
3. Information to the patient
about surgical protocol and
written informed consent for
Surgery and Anaesthesia
4. Patient to be sent to OT with
all required documents
consisting of details about the
patient

16. SURGICAL SAFETY MEASURES
AK 16
5) All swabs, needles and
instruments should be counted
before the incision and before closing
the surgical wound
6) In the event of wrong count, a
thorough search must be done and X
ray is done to find the missing
article.
7) Changes in OT list should be
avoided to prevent confusion

17. SURGICAL SAFETY MEASURES
AK 17
8) Diathermy patient plate should placed properly to
prevent burn injuries
9) Adequate pressure relieving aids used to avoid
pressure sores and nerve injuries
10) The patient should be positioned correctly and
secured with OT table accessories to prevent fall
during the surgery
11) Appropriate antibiotic and prophylaxis should be
given for prevention of infection

18. SURGICAL SAFETY MEASURES
AK 18
8) Diathermy patient plate should placed properly to
prevent burn injuries
9) Adequate pressure relieving aids used to avoid
pressure sores and nerve injuries
10) The patient should be positioned correctly and
secured with OT table accessories to prevent fall
during the surgery
11) Appropriate antibiotic and prophylaxis should be
given for prevention of infection

19. SURGICAL SAFETY MEASURES
AK 19
12) Continuous Monitoring during surgery to
maintain homeostasis/normal parameters
13) Careful positioning of patient to prevent nerve
injuries
14)Glycemic control for early wound healing
15)The operating theatre environment should be
optimized with regard to lighting, ventilation,
humidity and temperature

20. SURGICAL SAFETY MEASURES
AK 20
16) Additional equipment, such as diathermy and
tourniquets, should be used while recognizing their
potential complications to prevent accidents
17)Theatre etiquette including scrubbing, prepping
and draping and personnel movement is designed
to minimize cross infection
18) TRAINING
• - Periodic Training of OT staff regarding Patient
Safety Measures in the OT

21. Prevention of error- INTRA OPERATIVE PERIOD
AK 21
1) SURGICAL CHECK LIST

22. SURGICAL CHECK LIST
AK 22
A surgical safety checklist is a patient
safety communication tool that is used by a
team of operating room professionals
PURPOSE OF THE CHECKLIST
• To help operating room (OR) team to
remember important details that may be
missed during an operation
• To prevent adverse events that can occur
during the peri operative period

23. SURGICAL CHECK LIST
AK 23
IN 3 PARTS
SIGN IN
-Before induction of anaesthesia
-Ready to go back to the theatre
TIME OUT
-Before skin incision
- Safe to start operation or procedure
SIGN OUT
-Before patient leave operating room
-Safe to end operation and safe to send patient
to next point of care

24. SIGN IN
AK 24

25. TIME OUT
AK 25

26. SIGN OUT
AK 26

27. AK 27
SSI – surgical safety infection

28. SSI PREVENTION
AK 28
•Following Surgical handwashing before
surgery
•Following aseptic technique during
procedure
•Proper zoning of the OT
• Use of sterile instruments during surgery

29. SSI PREVENTION
AK 29
•Following proper disinfection and
sterilization measures in OT
•Using of antiseptic lotions to prepare the part
before surgery
•Using sterile drapes and dressings
•Limit the number of people present in
Operating room during procedure

30. SSI PREVENTION
AK 30
• Regular checking of surgical incision waound for
inflammation or infection
• Regular dressing of surgical incision during post
operative period
•

31. SSI PREVENTION
AK 31