Advice for patients about correct site surgery
By Thomas A. Cooper
(ARA) - A report published by the Institute of Medicine (IOM) in 2000 estimated that up to 98,000 people each year die due to preventable medical errors. That report also estimated the cost of these errors totals between $17 billion and $38 billion annually.
In its continuing efforts to reduce errors in the operating room, AORN, the Association of periOperative Registered Nurses, has initiated a “Patient Safety First” program, a comprehensive patient safety initiative for implementation in operating rooms and surgical centers nationwide.
AORN, a widely recognized authority on operating room safety, represents more than 40,000 members in 6,700 hospitals and 3,500 ambulatory surgery centers in all 50 states and around the world. Donna S. Watson, RN, CNOR, president of AORN, said that perioperative nurses have unique roles on the front lines where they care for patients before, during and after surgery.
“We believe that even one death due to error is too many,” Watson says. “Our program involves collaborating with other healthcare organizations, communicating with our members and providing useful information to the general public with the goal of reducing errors.”
The first area of focus for “Patient Safety First” is correct site surgery. Much has been reported about “wrong site” surgery, which is defined as any surgery performed on the wrong site or the wrong patient and/or performing the wrong procedure.
AORN’s “Advice for Patients Concerned About Correct Site Surgery” document is a set of guidelines for patients to use prior to undergoing a surgical procedure in order to ensure a positive outcome. The guidelines are as follows:
1. Be an active member of your health care team by taking part in every decision about your health care.
2. If you are having surgery or other invasive procedure, make sure that you and the health care professionals treating you all agree on exactly what will be done during the surgery or procedure.
3. Verify the information on your patient identity bracelet. Alert a member of the health care team if the information is incorrect and insist that it be replaced immediately.
4. Make sure the operative permit you sign includes the correct information about your surgical site (i.e., right or left) and procedure. Thoroughly read all medical forms and make sure you understand them before you sign any forms.
5. Ask to have the surgical or procedure site marked on your body with an indelible marker. If possible, be involved in marking the site.
6. Ask questions and speak up if you have any concerns. Keep asking questions until you understand the answers. Ask members of the health care team what steps will be taken to ensure your safety and correct site surgery.
7. Take a responsible family member or friend to accompany you to your doctor’s visits and on the day of your surgery or procedure so that they can serve as your advocate and speak up for you if you are unable.
8. Ask that your surgical team includes a registered nurse who is a member of AORN.
In addition to creating guidelines, AORN’s “Patient Safety First” program makes it possible for healthcare professionals to report concerns and incidences of medical error and ask safety questions using a toll-free hotline, or the “Patient Safety First” Web site. Additionally, AORN is developing a voluntary and anonymous reporting system of near misses in the surgical setting as a means of gathering practical information for use in creating its programs. The information collected will be analyzed and used in the development of new guidelines and products for use in surgical settings.
“We want nurses and doctors to be able to report errors and near misses anonymously so we can learn from their mistakes and take action to correct them,” Watson said. “We’re looking for stories and information about what actually happens in the operating room.”
In the coming year, AORN will expand the program to focus on additional priorities such as medication safety, infection control, counts and more. The list of safety areas to be addressed also includes patient positioning, communication, blood transfusion, retained foreign objects, burns, fires, equipment failure and staffing.
Thomas A. Cooper is executive director of AORN, the professional organization of perioperative registered nurses whose mission is to promote quality patient care by providing its members with education, standards, services, and
representation. AORN is composed of more than 40,000 perioperative registered nurses in the United States and abroad who manage, teach, and practice perioperative nursing; who are enrolled in nursing education; and who are engaged in perioperative research. Perioperative nursing practice is
defined as “those activities performed by the professional nurse in the preoperative, intraoperative, and postoperative phases of the patient’s surgical experience.”