Literature DB >> 21500609

Patient participation in surgical site marking: can this be an additional tool to help avoid wrong-site surgery?

Linda M Bergal1, Ran Schwarzkopf, Michael Walsh, Nirmal C Tejwani.   

Abstract

INTRODUCTION: Wrong-site surgery is defined as an operation conducted at the wrong site, on the wrong person, or resulting in the wrong procedure. Since 1993, more than 2200 wrong-site surgeries have been reported by the National Practitioner Data Base. A 2005 survey reported, 5.6% of replying academy fellows encountered a wrong-site surgery incident. Multiple interventions have been since suggested for prevention of these occurrences by the American Academy of Orthopaedic Surgeons and Joint Commission on Accreditation of Healthcare Organizations.
MATERIALS AND METHODS: This institutional review board-approved study was conducted to investigate patient compliance and reliability in marking the surgical site. Two hundred patients undergoing orthopedic surgery who agreed to participate were enrolled at the time of preoperative testing and clearance for surgery. The patients received instructions to mark the surgical site with a "YES." Patient data collected included age, sex, procedure type and location, history of previous orthopedic surgeries, workmen's compensation status or motor vehicle collision involvement, employment status, primary language, level of education, presence of depression or toxic habits, and the time between enrollment and day of surgery.
RESULTS: We achieved an overall compliance rate of 68.2%. There was no difference with respect to sex, tobacco use or history of depression, level of education or occupation, workmen's compensation, or government insurance status. The mean age of compliant patients was 48.6 years versus 53.3 years for those who did not comply (P = 0.05). About 72% of those who spoke English as a primary language complied, as opposed to 49% in others (P = 0.009). The time between enrollment and surgery was 10.4 days in compliant patients versus 23.1 days in noncompliant patients (P = 0.05). No statistically significant difference was noted with all other variables recorded. In no instance did patients mark the wrong side or make any marks likely to contribute to the wrong operation.
CONCLUSIONS: Patient's ability to be involved in this preventative measure is independent of most demographic variables previously thought to be significant. However, in view of the 68.2% compliance, patient involvement in surgical site marking is unreliable and may not help in decreasing the chances of wrong-site surgery.

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Mesh:

Year:  2010        PMID: 21500609

Source DB:  PubMed          Journal:  J Patient Saf        ISSN: 1549-8417            Impact factor:   2.844


  8 in total

1.  Applying fault tree analysis to the prevention of wrong-site surgery.

Authors:  Zachary A Abecassis; Lisa M McElroy; Ronak M Patel; Rebeca Khorzad; Charles Carroll; Sanjay Mehrotra
Journal:  J Surg Res       Date:  2014-09-06       Impact factor: 2.192

2.  Patient safety: reducing the risk of wrong tooth extraction.

Authors:  P Cullingham; A Saksena; M N Pemberton
Journal:  Br Dent J       Date:  2017-05-26       Impact factor: 1.626

Review 3.  [Wrong site surgery : Incidence, risk factors and prevention].

Authors:  P C Ambe; B Sommer; H Zirngibl
Journal:  Chirurg       Date:  2015-11       Impact factor: 0.955

Review 4.  Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review.

Authors:  Zackary Berger; Tabor E Flickinger; Elizabeth Pfoh; Kathryn A Martinez; Sydney M Dy
Journal:  BMJ Qual Saf       Date:  2013-12-13       Impact factor: 7.035

5.  Should nurses be allowed to perform the pre-operative surgical site marking instead of surgeons? A prospective feasibility study at a Swiss primary care teaching hospital.

Authors:  Judit Schäfli-Thurnherr; Annette Biegger; Christopher Soll; Gian A Melcher
Journal:  Patient Saf Surg       Date:  2017-04-04

Review 6.  Do patient engagement interventions work for all patients? A systematic review and realist synthesis of interventions to enhance patient safety.

Authors:  Bronwyn Newman; Kathryn Joseph; Ashfaq Chauhan; Holly Seale; Jiadai Li; Elizabeth Manias; Merrilyn Walton; Stephen Mears; Benjamin Jones; Reema Harrison
Journal:  Health Expect       Date:  2021-08-25       Impact factor: 3.377

7.  Feeling better on hemodialysis: user-centered design requirements for promoting patient involvement in the prevention of treatment complications.

Authors:  Matthew A Willis; Leah Brand Hein; Zhaoxian Hu; Rajiv Saran; Marissa Argentina; Jennifer Bragg-Gresham; Sarah L Krein; Brenda Gillespie; Kai Zheng; Tiffany C Veinot
Journal:  J Am Med Inform Assoc       Date:  2021-07-30       Impact factor: 7.942

Review 8.  Scoping review of patients' attitudes about their role and behaviours to ensure safe care at the direct care level.

Authors:  Lenora Duhn; Christina Godfrey; Jennifer Medves
Journal:  Health Expect       Date:  2020-08-05       Impact factor: 3.377

  8 in total

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