Measuring surgical safety during minimally invasive surgical procedures: a validation study.

Autor: Blikkendaal MD; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. m.d.blikkendaal@lumc.nl., Driessen SRC; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands., Rodrigues SP; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands., Rhemrev JPT; Department of Gynecology, Haaglanden Medical Center, P.O. Box 96900, 2509 JH, The Hague, The Netherlands., Smeets MJGH; Department of Gynecology, Haaglanden Medical Center, P.O. Box 96900, 2509 JH, The Hague, The Netherlands., Dankelman J; Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands., van den Dobbelsteen JJ; Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands., Jansen FW; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.; Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2018 Jul; Vol. 32 (7), pp. 3087-3095. Date of Electronic Publication: 2018 Jan 19.
DOI: 10.1007/s00464-018-6021-7
Abstrakt: Background: During the implementation of new interventions (i.e., surgical devices and technologies) in the operating room, surgical safety might be compromised. Current safety measures are insufficient in detecting safety hazards during this process. The aim of the study was to observe whether surgical teams are capable of measuring surgical safety, especially with regard to the introduction of new interventions.
Methods: A Surgical Safety Questionnaire was developed that had to be filled out directly postoperative by three surgical team members. A potential safety concern was defined as at least one answer between (strongly) disagree and indifferent. The validity of the questionnaire was assessed by comparison with the results from video analysis. Two different observers annotated the presence and effect of surgical flow disturbances during 40 laparoscopic hysterectomies performed between November 2010 and April 2012.
Results: The surgeon reported a potential safety concern in 16% (85/520 questions). With respect to the scrub nurse and anesthesiologist, this was both 9% (46/520). With respect to the preparation, functioning, and ease of use of the devices in 37.5-47.5% (15-19/40 procedures) a potential safety concern was reported by one or more team members. During procedures after which a potential safety concern was reported, surgical flow disturbances lasted a higher percentage of the procedure duration [9.3 ± 6.2 vs. 2.9 ± 3.7% (mean ± SD), p < .001]. After procedures during which a new instrument or device was used, more potential safety concerns were reported (51.2 vs. 23.1%, p < .001).
Conclusions: Potential safety concerns were especially reported during procedures in which a relatively high percentage of the duration consisted of surgical flow disturbances and during procedures in which a new instrument or device was used. The Surgical Safety Questionnaire can act as a validated tool to evaluate and maintain surgical safety during minimally invasive procedures, especially during the introduction of a new intervention.
Databáze: MEDLINE
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