UK
The National Patient Safety Agency and The Royal College of Surgeons of England act to protect surgical patients
By RCSENG, UK
Mar 11, 2005, 16:48

The National Patient Safety Agency (NPSA) and The Royal College of Surgeons of England recently jointly launched new advice to the NHS to help make surgery safer. The recommendations promoting �correct site surgery� encourage a consistent approach to marking the patient for surgery and provide staff with a checklist to ensure important steps have been taken to protect the patient.

This includes advice for surgical teams on where, how and when the patient should be marked to show where an operation should take place, who should mark the patient and the people who should be actively involved in the process.

The NPSA�s Medical Director, Professor Sir John Lilleyman said: �Mistakes during surgery can have devastating emotional and physical consequences for patients and their families. For the staff involved too, incidents can be distressing, while members of their clinical teams and the wider organisation can become demoralised and disaffected. Implementing these new recommendations will help surgical teams make patient care safer.�

Mr Hugh Phillips, President of The Royal College of Surgeons of England said: �We urge all surgical teams to adopt these guidelines. As the professional body committed to promoting and advancing the highest standards of surgical care for patients, the College has been working closely with the NPSA to ensure that the guidance is practical for our members and surgical teams across the NHS. The aim of the guidance is to promote best practice to help improve patient safety. �

A review of cases from the Medical Defence Union over 13 years from 1990 found 306 claims relating to �wrong�. Of these 39% were concerned with the wrong side. A fifth (20%) occurred in the specialty of Orthopaedics & Trauma. Close to half (49%) occurred in the specialty of dentistry and were concerned with the wrong tooth being removed.
Data from the NPSA�s National Reporting and Learning System (NRLS) pilot study involving 28 acute trusts between September 2001 and June 2002 identified 44 patient safety incidents associated with the word wrong, covering wrong procedure, site, operating list, consent, patient name and notes.

A further study involving 18 acute sites between November 2002 and April 2003 identified 15 patient safety incidents linked to wrong site surgery. Fortunately three of these were prevented, but two led to the wrong procedure and one related to intervention on the wrong side. The outcomes of the other nine were not recorded.

Endorsements

Kathy Evans, Chief Executive of The Royal College of Ophthalmologists said: "The Royal College of Ophthalmologists seeks to maintain proper standards in the practice of ophthalmology for the benefit of the public. It endorses the work of the National Patient Safety Agency and its objective of reducing unnecessary risk associated with medical procedures."

Prof Shaughn O�Brien, Vice President of The Royal College of Obstetricians and Gynaecologists (RCOG) said: �Because operating on the wrong anatomical site can have such devastating long-term consequences for the patient, the RCOG fully supports a consistent national approach that strives to make surgical procedures ever safer for patients.�

Dr Eileen M Scott, Chair of The Royal College of Nursing (RCN) Perioperative and Surgical Nursing Forum said: "The RCN Perioperative and Surgical Nursing Forum is pleased to endorse this timely document that will help to improve patient safety"

Melanie van Limborgh, Chairman of the National Association of Theatre Nurses (NATN) said: "Standardising marking and verification procedures for surgical patients will provide reassurance for patients and the public at large. The new guidance ensures that the whole theatre team is responsible for these checks rather than just the surgeon. NATN will continue working with the NPSA to promote Correct Site Surgery and is happy to endorse the excellent guidance in this Patient Safety Alert."

Janet Thatcher, Education Director of The National Association of Assistants in Surgical Practice (NAASP) said: �As part of the Surgical Team, NAASP members are keenly aware of the need for vigilance and checking to avoid errors within surgery. Within the organisation we are working to assist our members develop their own guidelines to provide an evidence-based structure for their practice. We see the NPSA�s patient safety alert as an important and welcome addition to the guidelines available to help ensure safe practice and protect patients from potential misunderstandings, and we are pleased to have been part of this development.�

Martin Smith, Chairman of the Association of Operating Department Practitioners (AODP) - professional body for Operating Department Practitioners said: "As a profession we have always embraced any developments that improve patient protection and safety and we were especially pleased to be part of this development for Correct Site Surgery recommendations. The correct identification of patients and operation sites is a vital part of patient care and one where improvements will directly affect the quality of that care. We will continue to work with the NPSA on future developments and projects and will ensure that such developments are firmly embedded in our pre registration curriculum and that all of our Registered Operating Department Practitioners are made fully aware of these recommendations."

Sally Taber, Head of Operational Policy of the Independent Healthcare Forum (IHF) said: �Acute healthcare providers belonging to the IHF are delighted to sign up to the Correct Site Surgery Safety Alert and are currently discussing the implementation of the pre-operative marking recommendations and verification checklist with all consultant users.�

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