Cochrane Researchers Identify Method to Reduce Incidences of Wrong-site Surgery

Posted on October 9, 2013

Ottawa (Sept. 19, 2012) – Wrong-site surgery is a rare but possibly disastrous clinical error that can have substantial consequences for patients and healthcare providers. Cochrane researchers have undertaken the task of identifying and evaluating interventions that may reduce wrong-site surgery.

Wrong-site surgery occurs when a procedure is undertaken on the wrong body part, the wrong patient or when the wrong procedure is performed. It includes both surgical and non-surgical invasive procedures, such as dermatological, obstetric and dental procedures, and emergency surgical procedures not undertaken within the operating theatre.

The authors of the recently released Cochrane Review set out to evaluate the effectiveness of current interventions used and suggest that incidences of wrong-site surgery may be reduced if organizational and professional strategies are put into place.

The review authors are members of The Cochrane Collaboration’s Effective Practice and Organisation of Care (EPOC) Group located in Ottawa at the Canadian Cochrane Centre. EPOC has satellites in international locations, and the authors of this review are affiliated with the satellite based in Melbourne, Australia.

The Cochrane Review reveals that in the context of wrong-site tooth extractions, implementing the use of an educational intervention focused specifically on wrong-site surgery, rather than surgical error in general, is a potentially effective way to reduce the number of mishaps. For optimal results, the intervention should target junior staff, examine previous wrong-site surgery cases, present examples of extraction errors, explain relevant clinical guidelines and provide feedback from an instructor.

An interrupted times series study was used to measure results, meaning that researchers examined one group of people and measured their behaviour at least three times before implementing the intervention and again at least three times afterwards. This type of study design ensures that results can be analysed correctly.

While the study focuses on wrong-site tooth extraction, the evidence shows clinically significant results, and with caution, the application of educational training programs to a broader population undergoing other forms of surgery may be effective in reducing the occurrence of wrong-site surgeries.

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