Wrong Sided Surgery
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The document discusses the Universal Protocol created by The Joint Commission to prevent wrong-sided surgeries, which are considered sentinel events. The Universal Protocol consists of three steps: 1) pre-procedure verification of the correct patient, procedure, and surgical site; 2) marking the intended surgical site before the procedure; and 3) a final timeout immediately before incision where the surgical team verbally confirms again the correct patient, procedure, and site. Following the Universal Protocol helps ensure effective communication and safety for patients undergoing surgical procedures.
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Universal Protocol
The Universal Protocol is a set of procedures implemented in 2004 to prevent wrong site, wrong procedure, and wrong patient surgery. It includes three key elements: pre-procedure verification, marking the intended site, and conducting a time-out immediately before starting the procedure. The goal is to use data on adverse events collected by JCI to prevent similar errors in other healthcare organizations.
Surgical Safety & Safer surgery
1. Safety is everybody’s business. According the Hippocratic oath from 5th century : “ Never do harm to anyone” Safer Surgery can be defined as a reduction in avoidable harm to a surgical patient
2. It is a part of medical specialty that uses operative manual and instrumental technique on a patient to investigate or treat a pathological condition. Surgical team: 1. Surgeon 2. Surgeon’s assistance 3. Anesthetist 4. Scrub nurse 5. Scouting nurse 6. Surgical technologist
3. Time or duration when patient admitted and discharge after completion of surgery. So, surgical safety has broadly included in different phases: 1. Preoperative(Diagnosis, investigation) 2. Per operative 3. Postoperative(Up to discharge)
4. 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.
5. An article in the Gurdian newspaper UK in March 2013 claimed that “five worst medical” nightmares a Pt faces, three related to surgery: 1. Wrong site surgery 2. Wrong patient surgery 3. Retained instruments and swabs The rate of harm in surgical patient is unknown but probably occur in about 10% surgical patient, though much of this harm will be minor.
6. 1. Patients themselves. 2. Healthcare professional 3. System failure. 4. Medical complexity
7. Patients Themselves 1. A variety of presentation. 2. Differing co-morbidities 3. Differing response to treatment 4. Patients are reluctant to speak up. 5. Refuse to co-operate 6. Hide and seek
8. Healthcare professional 1. Inadequate Pt assessment(delay or error in Diagnosis) 2. Failure to use or interpret appropriate test 3. Error in performance of an operation and test. 4. Inadequate monitoring or follow-up. 5. Deficient training or experience 6. Fatigue, overwork or time pressure. 7. Personal or psychological factor i.e. drug abuse or depression. 8. Lack of recognition of the danger of medical errors.
9. System failure 1. Poor communication between healthcare provider. 2. Inadequate staffing level 3. Overreliance on investigation 4. Lack of coordination at handover 5. Drug similarities. 6. Equipment failure due to lack of skilled operators. 7. Inadequate system to report and review patient safety incident.
10. Medical complexity 1. Advance and new technologies(laparoscopic, robotic surgery) 2. Potent drug and their side effects and interaction. 3. Working environment- Surgical ICU, HDU and Operation theatre
11. Surgery is one of the most complex health intervention to deliver. More than 100 million people worldwide require surgical treatment every year for different reason. Great Professor of Surgery Sir Alfred Cuschieri and other describes surgical errors in different categories that committed by the surgeons during care of the Patients.
12. 1. Diagnosis and management erro
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The Universal Protocol is a set of procedures implemented in 2004 to prevent wrong site, wrong procedure, and wrong patient surgery. It includes three key elements: pre-procedure verification, marking the intended site, and conducting a time-out immediately before starting the procedure. The goal is to use data on adverse events collected by JCI to prevent similar errors in other healthcare organizations.
Surgical Safety & Safer surgery
1. Safety is everybody’s business. According the Hippocratic oath from 5th century : “ Never do harm to anyone” Safer Surgery can be defined as a reduction in avoidable harm to a surgical patient
2. It is a part of medical specialty that uses operative manual and instrumental technique on a patient to investigate or treat a pathological condition. Surgical team: 1. Surgeon 2. Surgeon’s assistance 3. Anesthetist 4. Scrub nurse 5. Scouting nurse 6. Surgical technologist
3. Time or duration when patient admitted and discharge after completion of surgery. So, surgical safety has broadly included in different phases: 1. Preoperative(Diagnosis, investigation) 2. Per operative 3. Postoperative(Up to discharge)
4. 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.
5. An article in the Gurdian newspaper UK in March 2013 claimed that “five worst medical” nightmares a Pt faces, three related to surgery: 1. Wrong site surgery 2. Wrong patient surgery 3. Retained instruments and swabs The rate of harm in surgical patient is unknown but probably occur in about 10% surgical patient, though much of this harm will be minor.
6. 1. Patients themselves. 2. Healthcare professional 3. System failure. 4. Medical complexity
7. Patients Themselves 1. A variety of presentation. 2. Differing co-morbidities 3. Differing response to treatment 4. Patients are reluctant to speak up. 5. Refuse to co-operate 6. Hide and seek
8. Healthcare professional 1. Inadequate Pt assessment(delay or error in Diagnosis) 2. Failure to use or interpret appropriate test 3. Error in performance of an operation and test. 4. Inadequate monitoring or follow-up. 5. Deficient training or experience 6. Fatigue, overwork or time pressure. 7. Personal or psychological factor i.e. drug abuse or depression. 8. Lack of recognition of the danger of medical errors.
9. System failure 1. Poor communication between healthcare provider. 2. Inadequate staffing level 3. Overreliance on investigation 4. Lack of coordination at handover 5. Drug similarities. 6. Equipment failure due to lack of skilled operators. 7. Inadequate system to report and review patient safety incident.
10. Medical complexity 1. Advance and new technologies(laparoscopic, robotic surgery) 2. Potent drug and their side effects and interaction. 3. Working environment- Surgical ICU, HDU and Operation theatre
11. Surgery is one of the most complex health intervention to deliver. More than 100 million people worldwide require surgical treatment every year for different reason. Great Professor of Surgery Sir Alfred Cuschieri and other describes surgical errors in different categories that committed by the surgeons during care of the Patients.
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QPG learning sharing one of the checklist issued by WHO to be followed by surgeons , nurses and anesthetists during whole #surgery to maintain quality in surgical process
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This document provides an overview of minimal invasive surgery. It defines minimal invasive surgery as aiming to accomplish surgical goals with minimal somatic and psychological trauma using reduced wound access. The core principles of laparoscopic surgery are summarized as insufflate, visualize, identify, triangulate, retract, operate, and seal. The main types of minimal invasive surgery are then described. The advantages are outlined as reduced wound size, pain, and recovery time while the disadvantages include loss of tactile feedback and reliance on new techniques. Preoperative evaluation, contraindications, operative problems, postoperative care, discharge criteria and basic surgical principles are also summarized. Robotic surgery is introduced as computer-enhanced surgical devices that provide steadier images and fewer incisions
perioperative_nursing_management_ksu_1.ppt
This document discusses pre, intra, and postoperative nursing management. It describes the three phases of the perioperative period and provides details about nursing interventions in each phase. In the preoperative phase, nursing focuses on psychological preparation, informed consent, and physiological assessment. During surgery, nurses serve as circulating or scrub nurses to provide a safe environment and assist the surgical team. In recovery, nursing aims to monitor vital signs, manage pain and complications, and encourage early mobilization.
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Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
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1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
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Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Wrong Sided Surgery
- 1. Wrong Sided Surgeries The Universal Protocol By: Annette Terranova, RN
- 2. Wrong Sided Surgery Statistics • Numerous surgeries are performed everyday • Someone you know has had surgery • Wrong sided surgeries can be devastating • Wrong Sided surgeries are called Sentinel Event
- 3. The Joint Commission • An organization committed to improving healthcare • Major focus on patient safety • The governing body of Sentinel Events • Sentinel Event Policy created in 1996 • The Universal Protocol -created to prevent wrong sided surgeries
- 4. Pre-Procedure Verification Process • First Step of the Universal Protocol • Review of patient’s chart for • correct documentation • Imaging and labs • special equipment for the procedure • Verification of • correct procedure • correct patient • correct surgical site
- 5. Mark the Procedure Site • Second step in the Universal Protocol • To be done before procedure • To be marked at or near the surgical site • Surgeon and patient or family initial site
- 6. Perform a Timeout • Final step of the Universal Protocol • Occurs moments prior to incision • All members of the surgical team are involved • The Timeout is standardized in all rooms • Verbal agreement of • correct procedure • correct patient • correct surgical site
- 7. How it Helps • Centers for Medicare and Medicaid Services (CMS) is requiring it for reimbursement • Creates effective communication • Ensures safe practices • Increases safety for the patient
- 8. Bibliography • The Joint Commission. (2017). Facts about patient safety. https://www.jointcommission.org/facts_about_patient_safety/ • The Joint Commission. (2017). Safe surgery checklist. https://www.jointcommission.org/safe_surgery_checklist/ • The Joint Commission. (2017). The Universal Protocol. https://www.jointcommission.org/assets/1/18/UP_Poster1.PDF