IMPACT OF SECURITY POLICIES IN OPERATING ROOMS
NURSING VI
PRESENTED TO:
ESPERANZA GONZALEZ ARANGO
PRESENTED BY:
MARIA ANGELICA MORALES RIVERA
FOREST UNIVERSITY (ponga el nombre de la universidad en español )
NURSING VI
02/09/2019
According to the Technical Guide “Good practices for patient safety in health care” of the
Ministry of Social Protection 2010 (1), the World Health Organization (WHO) works
strictly to reduce the number of deaths in the surgery ward, based on the advice of hospital
staff, experts in patient safety and patients worldwide, the World Alliance for Patient
Safety, which is a (WHO) department, had the initiative to implement a program called “
Safe surgery saves lives ”, this program seeks to cover topics of interest such as: poor
anesthesia safety practices, proliferation of surgical infections and poor or no
communication between members of the surgical team, for this reason, 3 checklists are
applied that must be performed during an operation with the main objective of safe practice
during surgery and to encourage teamwork, since they are necessary to achieve a successful
surgery; These lists are available in virtual or physical manuals. Therefore, it is important to
ask, what are the 3 checklists? What is the positive impact of applying these lists and what
is the negative impact of not applying these checklists, designed by the (WHO) in the
program "Safe Surgery’s save lives”?
For starters, let's talk about the "surgical team" who is composed of a surgeon, the
anesthesiologist, or a nurse, specialized technicians and other operating room personnel,
amongst this team you will find the "list coordinator" who is in charge of completing the
checklist before, during and after the surgical procedure, this list will divide the surgery in
three phases, these phases are entry, surgical pause and the end, in these phases the list
coordinator confirms that the staff assisting in the operating room has carried out its
specific tasks.
After this, the first phase 1 Entry, occurs before administering anesthesia. This phase is
performed in order to mitigate potential complications during the course of the surgery,
therefore, the coordinator of the list shall perform an assessment directly with the patient (if
possible) if you cannot make this assessment with the patient information will be gathered
from third parties such as family or dependents and they will be asked for the following
information: your identity, anatomical site where the surgery will be performed and the
procedure, in this evaluation, you will inquire about authorization or consent to be operated
on surgically. After this, the coordinator will inspect the identified location of the surgical
site, posture and proper function of the pulse oximeter, they will meet with the anesthetist
to identify the risk of bleeding, scale mallapaty, allergic history and finally check the
adequate operation of the anesthesia team, checking each of their instruments for
successful surgery.
Source: World Health Organization. WHO list check the safety of surgery manual
application. Espanol
After having implemented the first phase of the checklists, the second phase follows.
Surgical pause refers to the time prior to the administration of anesthesia and minutes
before surgery, this stage is aimed to recognize the personal assisting in the operating room,
where everyone must announce their role during the surgical procedure and the anatomic
site of the surgery aloud, also use their checklist to verbally review the key points of the
surgery each attendee, will also perform a confirmation of the prophylactic to be
administered, and insure the visualization of the essential images from the studies.
Source: World Health Organization. WHO list check the safety of surgery manual
application. Espanol
Finally, the third phase of the checklist. Output, this phase is between closing the surgical
wound and prior to output of the OR patient, the main objective is, planning postoperative
therapy to the patient; before the exit of the patient from the operating room, the surgical
team performs a count of the materials and supplies used during surgical practice, and
labeled biological samples obtained from the patient.
Source: World Health Organization. WHO list check the safety of surgery manual
application. Espanol
From the following one can demonstrate that the implementation of the checklists in the
operating room will help find both positive and negative impact during the use or non-use
of these checklist, likewise you will find some advantages and disadvantages:
Positive impacts by applying Negative impacts of not
all 3 phases applying in the three phases
Phase 1: Before By applying at this stage, you Failure to apply at this phase,
induction of anesthesia will ensure the quality of the you might make a mistake, in
procedure and will reduce the reference to the surgery of the
risk of mortality and patient or the wrong
complications during surgery anatomical site.
and postoperatively.
Phase 2: surgical pause By applying at this phase you Failure to apply at this phase.
recognize the surgical group events may occur such as
that will be attending during threatening the life of the
surgery, it is useful as each patient, applying at this stage
staff performs a specific can prevent damages or
function that may or may not availability of the surgical
interfere with the function of equipment.
the other, you can also
prepare all the materials
needed, whether materials for
blood transfusions, or
diagnostic imaging, among
others.
Phase 3: Output By applying this phase, you Failure to apply at this phase,
can be review problems or errors that would have been
errors that occurred during generated during the surgical
surgery to avoid them in procedure are not identified
future surgery’s. it can also be and it can become repetitive
used to identify anything and may even threaten the life
required during surgery or the of the patient it could also
studies to decrease surgical cause the identification of
cost. adverse events not to occur
like during anesthesia that can
complicate patient recovery.
Advantage Disadvantages
The lists are ran by one person, so this will The checklist being directed by one person,
allow each phase to be carried out in an will cause contrapositions from members
organized manner. present in the operating room because there
may be staff that is not in accordance with
the standards of this list.
In using the checklist continuously, it will If it’s not directed by a coordinator, you
create habit or project familiarization and can skip steps to reach the timeframe
staff who carry out the tasks required will proposed for phases of the checklists.
be able to do so without the participation of
a coordinator
Immediate surgical events you can get to
omit steps of checklists.
Finally, in the "Application Manual WHO checklist of surgical safety" of the World Health
Organization in 2009 (2), it is explained clearly, how to carry out these checklists, because
by implementing these lists continuously in an operating room, surgical teams become
more familiar and carry out their tasks without the participation of the coordinator
completing all the steps correctly.
In conclusion, the implementation of these checklists, may cause oppositions, because in
case of emergencies or immediate surgeries the intervention will be considered as waste of
time, however it will be useful, because with these lists will lend quality care, because the
quality of the work is measured not only by the time they performing surgery, but the
quality of care or the success of the surgery; With these lists comes the improvement of
care emphasizing humane treatment and mortality reduction in operating rooms since.
Various complications due to lack of communication between staff in the operating room
and performing the surgical procedure immediately have caused errors like operating on the
wrong anatomical site or even loosing a life due to medical malpractice.
Bibliography
1. (1) World Health Organization. WHO list check the safety of surgery manual
application. Edition (1). Place of publication: France. Editorial WHO; 2008.
2. (2) World Health Organization. Implementation Manual WHO safety verification
surgery. Editorial NLM. 2009.
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