United States brings in new rules to prevent surgical errors
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《英国医生杂志》
New rules in the United States that came into effect this week require doctors and hospitals to take certain specified steps to prevent operating on the wrong body part or wrong patient.
Among the requirements, surgeons and nurses must take what is being referred to as "time out" before operating on patients, to confirm that the right patient is on the table and that doctors are operating on the right body part and the right side of the body.
Hospital regulators hope the rules, which came into effect on 1 July, will put an end to growing reports of operations on the wrong site or the wrong patient or that involved the wrong procedure.
"These should never happen," said Dr Dennis O'Leary, who heads the Joint Commission on Accreditation of Healthcare Organizations, the agency that accredits medical facilities in the United States, allowing them to continue to operate. The agency can revoke the accreditation of hospitals or other surgery sites that don't comply with the new safety steps.
No precise figures on exactly how many such mistakes occur are available, because the commission receives only voluntary reports. It is assumed that the reports are only a small percentage of the 70 million operations done in the United States each year.
A marked thoracotomy incision, signed by the surgeon, to show the correct side for the operation.
Credit: MARK THOMAS
More than 40 million in-patient surgical procedures and 31 million outpatient procedures are performed each year in the United States. The commission calculated that from 1995 to the end of January 2004 there were 300 cases of surgical errors involving the wrong part or side of the body, the wrong procedure, or the wrong patient.
Of the 300 cases some 59% involved surgeons operating on the wrong side of a patient. Ten per cent of the cases involved the wrong surgical procedure and 12% the wrong patient. Another 19% involved the wrong site on the body.
One of the new rules is that surgeons must literally sign the incision site—while the patient is awake and cooperating if possible—with a marker that will not wash off in the operating room.
The whole operating team must also stop all other work just before surgery begins and go through a checklist to ensure that the correct patient is on the table and that everyone—surgeons, nurses, anaesthetists, and technicians—agrees what procedure is being done, on what body part.
More than 40 medical organisations, including the American Academy of Orthopedic Surgeons, have now signed up to help the accreditation commission teach the new rules.(Scott Gottlieb)
Among the requirements, surgeons and nurses must take what is being referred to as "time out" before operating on patients, to confirm that the right patient is on the table and that doctors are operating on the right body part and the right side of the body.
Hospital regulators hope the rules, which came into effect on 1 July, will put an end to growing reports of operations on the wrong site or the wrong patient or that involved the wrong procedure.
"These should never happen," said Dr Dennis O'Leary, who heads the Joint Commission on Accreditation of Healthcare Organizations, the agency that accredits medical facilities in the United States, allowing them to continue to operate. The agency can revoke the accreditation of hospitals or other surgery sites that don't comply with the new safety steps.
No precise figures on exactly how many such mistakes occur are available, because the commission receives only voluntary reports. It is assumed that the reports are only a small percentage of the 70 million operations done in the United States each year.
A marked thoracotomy incision, signed by the surgeon, to show the correct side for the operation.
Credit: MARK THOMAS
More than 40 million in-patient surgical procedures and 31 million outpatient procedures are performed each year in the United States. The commission calculated that from 1995 to the end of January 2004 there were 300 cases of surgical errors involving the wrong part or side of the body, the wrong procedure, or the wrong patient.
Of the 300 cases some 59% involved surgeons operating on the wrong side of a patient. Ten per cent of the cases involved the wrong surgical procedure and 12% the wrong patient. Another 19% involved the wrong site on the body.
One of the new rules is that surgeons must literally sign the incision site—while the patient is awake and cooperating if possible—with a marker that will not wash off in the operating room.
The whole operating team must also stop all other work just before surgery begins and go through a checklist to ensure that the correct patient is on the table and that everyone—surgeons, nurses, anaesthetists, and technicians—agrees what procedure is being done, on what body part.
More than 40 medical organisations, including the American Academy of Orthopedic Surgeons, have now signed up to help the accreditation commission teach the new rules.(Scott Gottlieb)