Koirala Diwakar, Kumar Abhijeet, Baniya Aashish, Sapkota Ramesh, Mishra Bivek
Department of Surgery B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Ann Med Surg (Lond). 2025 Aug 1;87(9):5442-5447. doi: 10.1097/MS9.0000000000003663. eCollection 2025 Sep.
Surgical errors are a significant concern in medical practice, particularly in teaching institutions where trainees are frequently involved in patient care. These errors, which include deviations from standard surgical procedures, can lead to adverse patient outcomes in one hand whereas emotional distress among surgeons on the other hand as well. Understanding the prevalence, types, and coping mechanisms for surgical errors is essential for developing effective strategies to minimize their occurrence and impact.
This cross-sectional study involved 134 surgeons from various specialties at B.P. Koirala Institute of Health Sciences (BPKIHS), with 50.7% being resident doctors. A total of 79.1% admitted to committing surgical errors during their careers at some points of time. All errors, self-accepted by surgeons enrolled in the study were minor ones. Frequently reported errors included inappropriate incision (77.5%), anesthesia titration errors (75.7%), and unintentional organ/tissue injury (69.2%). Female surgeons were more likely to self-report errors than male surgeons. All errors had occurred during the early phase of surgical training. Surgeons attributed errors to systemic and personal factors, including insufficient staffing, fatigue, and poor communication. Common coping strategies included escape and self-instruction, though not all were effective in mitigating stress.
The high incidence of minor errors seems to be acceptable part of learning in teaching institute where trainees are frequently involved in patient care. None of the error was major because in teaching institute like ours, the trainees are at frontline in patient care but are always under supervision of senior clinicians. All errors have occurred during the early phase of surgical training. There is need of targeted interventions, including training, support systems, and institutional reforms to reduce surgical errors and improve surgeon well-being.
手术失误是医疗实践中的一个重大问题，尤其是在教学机构中，实习生经常参与患者护理。这些失误包括偏离标准手术程序，一方面会导致患者出现不良后果，另一方面也会给外科医生带来情绪困扰。了解手术失误的发生率、类型和应对机制对于制定有效的策略以尽量减少其发生和影响至关重要。
这项横断面研究涉及来自BP柯伊拉腊健康科学研究所（BPKIHS）各个专业的134名外科医生，其中50.7%是住院医生。共有79.1%的人承认在其职业生涯中的某些时候犯过手术失误。参与该研究的外科医生自我承认的所有失误都是轻微失误。经常报告的失误包括切口不当（77.5%）、麻醉滴定错误（75.7%）和意外的器官/组织损伤（69.2%）。女外科医生比男外科医生更有可能自我报告失误。所有失误都发生在手术培训的早期阶段。外科医生将失误归因于系统和个人因素，包括人员不足、疲劳和沟通不畅。常见的应对策略包括逃避和自我指导，尽管并非所有策略都能有效减轻压力。
在实习生经常参与患者护理的教学机构中，轻微失误的高发生率似乎是学习过程中可以接受的一部分。没有一个失误是重大失误，因为在我们这样的教学机构中，实习生处于患者护理的第一线，但始终受到资深临床医生的监督。所有失误都发生在手术培训的早期阶段。需要有针对性的干预措施，包括培训、支持系统和机构改革，以减少手术失误并改善外科医生的健康状况。
