Giles Sally J, Rhodes Penny, Clements Gill, Cook Gary A, Hayton Ruth, Maxwell Melanie J, Sheldon Trevor A, Wright John
University of Liverpool, Stepping Hill Hospital, Stockport, UK.
Qual Saf Health Care. 2006 Oct;15(5):363-8. doi: 10.1136/qshc.2006.018333.
Little is known about the incidence of "wrong site surgery", but the consequences of this type of medical error can be severe. Guidance from both the USA and more recently the UK has highlighted the importance of preventing error by marking patients before surgery.
To investigate the experiences of wrong site surgery and current marking practices among clinicians in the UK before the release of a national Correct Site Surgery Alert.
38 telephone or face-to-face interviews were conducted with consultant surgeons in ophthalmology, orthopaedics and urology in 14 National Health Service hospitals in the UK. The interviews were coded and analysed thematically using the software package QSR Nud*ist 6.
Most surgeons had experience of wrong site surgery, but there was no clear pattern of underlying causes. Marking practices varied considerably. Surgeons were divided on the value of marking and varied in their practices. Orthopaedic surgeons reported that they marked before surgery; however, some urologists and ophthalmologists reported that they did not. There seemed to be no formal hospital policies in place specifically relating to wrong site surgery, and there were problems associated with implementing a system of marking in some cases. The methods used to mark patients also varied. Some surgeons believed that marking was a limited method of preventing wrong site surgery and may even increase the risk of wrong site surgery.
Marking practices are variable and marking is not always used. Introducing standard guidance on marking may reduce the overall risk of wrong site surgery, especially as clinicians work at different hospital sites. However, the more specific needs of people and specialties must also be considered.
关于“手术部位错误”的发生率所知甚少，但这类医疗差错的后果可能很严重。美国以及最近英国的指导意见都强调了术前对患者进行标记以预防差错的重要性。
在全国性“正确手术部位警报”发布之前，调查英国临床医生在手术部位错误方面的经历以及当前的标记做法。
对英国14家国民保健服务医院的眼科、骨科和泌尿外科的外科顾问医生进行了38次电话或面对面访谈。访谈内容使用QSR Nud*ist 6软件包进行编码和主题分析。
大多数外科医生都有手术部位错误的经历，但根本原因没有明显模式。标记做法差异很大。外科医生在标记的价值上存在分歧，做法也各不相同。骨科医生报告说他们在手术前进行标记；然而，一些泌尿科医生和眼科医生报告说他们不这样做。似乎没有专门针对手术部位错误的正式医院政策，而且在某些情况下实施标记系统存在问题。用于标记患者的方法也各不相同。一些外科医生认为标记是预防手术部位错误的一种有限方法，甚至可能增加手术部位错误的风险。
标记做法各不相同，并非总是采用标记。引入关于标记的标准指导可能会降低手术部位错误的总体风险，特别是当临床医生在不同医院工作时。然而，也必须考虑人员和专业的更具体需求。
