Perioperative Care; Fluid and Electrolyte

Improving Patient Safety in the Surgical Environment

Protocols and procedures to identify and manage stress and fatigue in surgical personnel may help to avoid surgical errors and patient injuries. The operating room is an appropriate educational environment, but the presence of observers at any level must not be allowed to compromise patient safety. Patient safety in surgery demands the full attention of skilled individuals using well-functioning equipment under adequate supervision.

All members of the operating room team also should postpone nonessential conversation until surgery is finished. Similarly, it may be preferable to ask nonessential personnel to remain outside the operating room while surgery is being performed. Everyone on the team is mutually accountable for minimizing distractions.

The education process in these environments presents special challenges in protecting patient safety. It is a fundamental principle that all trainees must be meticulously supervised and assisted when participating in surgery. Both the trainee and the supervisor should be alert, well rested, and well prepared in advance for the surgical procedure being performed. Because patient safety depends on effective communication.

Statement on the prevention of retained foreign objects after surgery, the American College of Surgeons recommends consistent application and adherence to standardized counting procedures and documentation of the surgical counts, instruments or items intentionally left as packing, and actions taken if count discrepancies occur.