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Structurally, health care sectors lack definite constructs on safety evaluations in patient treatment and interventions; unfortunately, deficits in evaluative efforts to foresee improvements in health teams’ “ongoing knowledge, or use of a policy to avert.future adverse event” (Michaels et al., 2007, p. 526). Much as the truth hurts, strong commitment in both government and private health sectors are insufficient in fighting for the rights of public to safe and quality health treatment.
Admittedly, variety of health organizations are already aware of discrepancies in surgical errors and are now setting guidelines for marking safeguards against negative health impacts of negligence in professional practice. Among the external agencies concerned on quality clinical practices in all medical areas are Healthcare Organizations (JCAHO), the National Patient Safety Initiative, the American College of Surgeons (ACS), the New York State Department of Health (NYS DOH), and the Agency for Healthcare Research and Quality (AHRQ).
They are of different organizational team, but are united in setting specific benchmarks that address problems in the surgical environment, especially with rampant errors in wrong-site surgery. In import, clinical monitoring is initiated by JCAHO, series of investigations are conducted on the increasing malpractice complaints and reviewed 150 relevant cases to determine its root causes. Majority (66%) of results are pointed on errors in surgical site (The Joint Commission, 2001). The outcome affirms rising cases of wrong site surgery in clinical institutions.
To relieve from government pressures, above-mentioned health organizations generated their own version of clinical practices that address the problems with wrong-side surgery in all institutional categories. Consistently integrated in internal institutional policies, suggested implementation strategies to prevent further surgical damage include “marking the surgical site and involving the patient in the marking process, creating and using verification checklist.obtaining oral verification of the patient, surgical site, and procedure.
by each member of the surgical team, monitoring compliance with these procedures.(and as part of verification) surgical teams consider time-out” (The Joint Commission, 2001, p. 2). Most consider such actions as universal in protocol, and almost every hospital adapt these as protective program measures for safety and quality surgical interventions. In prudent ways, the multiple dynamics in verification process in pre-anesthesia period, and even prior to actually starting the surgical procedure, through the “time-out” process of pausing to review before initiating an incision on the site, seemed prudent strategies to give the surgical team every opportunities to confirm whether the right site had been indicated and marked by the surgeon-in-charge.
Subtly, every action denote a number of communication patterns, in verbal, written and demonstrative means, that constantly reminds the health team that what they are surgically embarking is clinically appropriate. In such cases, the series of clinical prompts are not enough, especially when internal culture dictates barriers in communication, as extensively translated in overt behaviors from authoritative surgeons down to circulating nurses. In particular, the case sample on an elderly man indicated for left-side biopsy, which ended up as victim of wrong site sur
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