The World Health Organisation (WHO), the United Nation’s agency for health, which scans the public health conditions in the countries, on Wednesday has released a new checklist for the hospitals and the surgeons, for making surgery safer as per viewing that one out of 150 patients dies during or after surgery in some operating-room errors.
The new checklist has been prepared in the leadership of Indian origin doctor Dr. Atul Gawande who is a doctor and professor at Howard School of Public Health in Howard University, USA.
As per WHO observation, about one out of every 25 people undergo surgery a significant percent of operated patients face preventable complications and deaths.
Thus, for driving surgery safer around the world, WHO launched a new safety checklist for surgical teams to use in operating theatres, as per WHO stated in a press release on Wednesday.
According to WHO, which revealed the data on the basis of several studies, “Globally, about 234 million major surgical operations are conducted a year. This equates to about one operation for every 25 persons. Every year 63 million people undergo surgery to treat traumatic injuries, another 10 million for pregnancy-related complications, and 31 million more for treating cancers.”
“In industrial countries major complications occur in 3% to 16% of inpatient surgical procedures, and permanent disability or death rates are about 0.4% to 0.8%,” as WHO stated in the release by adding that in developing countries, death rates are higher, 5% to 10% during major operations.
“Mortality from general anesthesia alone is reported to be as high as one in 150 in parts of sub-Saharan Africa. Infections and other postoperative complications are also a serious concern around the world. These studies suggest that about half of these complications may be preventable,” reported WHO.
In this regard, on the instruction of WHO, Dr. Atul Gawand has made a new checklist identifying a set of surgical safety standards that can be applied in all countries and health settings, ‘would be successful to double the likelihood of the patient who would go under proven standards of surgical care,’ claimed WHO on the basis of preliminary results from a thousand patients in eight pilot sites worldwide.
“Use of the checklist in pilot sites has increased the rate of adherence to these standards from 36% to 68% and in some hospitals to almost 100%. This has resulted in substantial reductions in complications and deaths in the 1000 patients. Final results on the impact of the checklist are expected in the next few months,” said WHO.
Describing the essentiality of surgery, Dr, Atul stated, “Surgical care has been an essential component of health systems worldwide for more than a century… The Safe Surgery Saves Lives initiative aims to change this by raising the standards that patients anywhere can expect.”
Describing the improvement since last three decades in operation procedure and fields, Dr. Gawande said, “Although there have been major improvements over the last few decades, the quality and safety of surgical care has been dismayingly variable in every part of the world.”
Illustrating about the checklist, WHO said that 50 percent surgical site infection can be prevented by improving the surgery timing and by selecting proper antibiotics prior to skin incision.
“The checklist identifies three phases of an operation, each corresponding to a specific period in the normal flow of work: before the induction of anaesthesia (‘sign in’), before the incision of the skin (‘time out’) and before the patient leaves the operating room (‘sign out’). In each phase, a checklist coordinator must confirm that the surgery team has completed the listed tasks before it proceeds with the operation. For instance, during the ‘sign in’ phase, the coordinator should check whether the surgical site on the patient's body was properly marked and whether the patient's known allergies were checked. During the ‘sign out’ phase, instruments, sponges and needles should be counted to check that none of these is accidentally left behind in the patient's body.” said WHO indicating the few points for new surgical standard checklist.
This released checklist will be finalised for distribution by the end of 2008 after completing the studies of eight pilots and existing these results.
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