tailieunhanh - Safer Surgery part 37

Safer Surgery part 37. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 334 Safer Surgery The high incidence of distracters suggests that both the opportunity for and tolerance of external interference was high. Instances of reduced safety consciousness were also high which was surprising considering the well-recognized and highly undesirable effect that nosocomial infection can have on the outcome of joint replacement surgery Gao et al. 2000 . Though equivocal evidence has been offered for the effectiveness of mask discipline for control of nosocomial infection McLure et al. 1998 Mitchell and Hunt 1991 protocols should be applied consistently and particular attention should be paid to prosthetic implantation Woodhead et al. 2002 . Controlling the use of the telephone in theatre and reinforcing safety procedures are simple and direct solutions that could and should be applied. On a number of occasions senior team members attempted to maintain standards with little success and in one instance an individual not involved with the operation entered the theatre during the procedure initially without a mask made a loud and argumentative phone call without the permission of anyone in the operating team then left theatre violating mask protocol on the way out. Failures to control distraction and safety are therefore symptomatic of the impact of culture on surgical quality Baird et al. 2005 and rather than blaming individuals the aetiology of this problem should be considered at all levels from hospital management through professional societies and associations to national policy. Unlike other types of surgery which may be reliant on the scalpel-and-suture skills of the surgeon TKR and TKR revision operations are reliant on the appropriate use of procedure-specific instruments. Achieving the correct equipment configuration is a key technical skill for this type of surgery. Though the instruments are usually reliable the wide range of equipment required in a short space of time placed pressure on the operating team. For example the ten-minute .