In this study Operating team/ surgical teammeans a team which includes surgeons, anesthesiologists, nurses, techniciansand other OR personnel.
The World Health Organization has(WHO) given a detailed description and glossary on Patient safety Concepts andReferences, 2009. As per the glossary, the following are the definitions: 1. Safetyculture – The safety culture of anorganization is the product of individual and group values, attitudes,perceptions competencies, and patterns of behavior that determine thecommitment to, and the style and proficiency of, an organization’s health andsafety management. 2. An adverse event- an injury that was caused by medical management or complication instead ofthe underlying disease and that resulted in prolonged hospitalization or disabilityat the time of discharge from medical care, or both OR Aninjury that was caused by medical management and that results in measurabledisability OR An event that results in unintended harm to the patient by an actof commission or omission rather than by the underlying disease or condition ofthe patient 3. Healthcare-Services of health care professionals and their agents that are addressed at(1) health promotion; (2) prevention of illness and injury; (3) monitoring ofhealth; (4) maintenance of health; and (5) treatment of diseases, disorders,and injuries in order to obtain cure or, failing that, optimum comfort andfunction (quality of life) 4. A nearmiss – an event that almost happened or anevent that did happen but no one knows about. If the person involved in thenear miss does not come forward, no one may ever know it occurred OR An eventor situation that could have resulted in an accident, injury or illness, butdid not, either by chance or through timely intervention 5.
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A critical incident – Anincident resulting in serious harm… to the patient… when there is an evidentneed for immediate investigation and response. OR any unintended event that occurswhen patients receive treatment in hospitals thatresults in death, serious disability, injury, or harm, and does not result primarily from the patient’s underlyingcondition or a known risk in providing treatment. 6. Medical error -an adverse event that is preventable with the current state of medicalknowledge. 7. Sentinel event-An unexpected occurrence involving death or serious physical or psychologicalinjury, or the risk thereof.
Serious injury specifically includes loss of limbor function. The phrase or risk thereof includes any process variation forwhich a recurrence would carry a significant chance of a serious adverseoutcome. Such events are called ‘sentinel’ because they signal the need forimmediate investigation and response.
Adverse events can be classified in three categoriesbased on a study conducted by Joint Commission on sentinel events.i. Communication- including communication with thepatient and among members of the surgical team; availability of information;and operating room hierarchy;ii. Patient management- such as preoperativeassessment of the patient;iii. Clinical performance- including orientation andtraining, the procedures used to verify the operative site, and distraction.Alternatively, these areas could represent the clinical or management processesthat are associated with events without any judgments about root causes withinthose processes. SURGICAL SAFETY CHECKLSTThe surgical safety checklistis a series of events or task that a surgical team (surgeons, anesthetists,clinician, and nurse etc.
staff involved in the surgery) has to address during perioperativeperiod to improve the patient safety. Each task included in this checklist byWHO is based on clinical evidence/ expert opinion from different field.The ultimate goal of theWHO Surgical Safety Checklist is to ensure that operating teams regularlyfollow certain critical safety steps and therefore minimize the most common andavoidable risks which can cause harm to lives and well-being of surgicalpatients.In order to implement thechecklist a single person must be responsible for checking the list, mostlythis task is given to a circulating nurse and the this person is known as thechecklist coordinator.