Patient Safety in the Operating Room

Abstract

Maintaining patient safety in the operating room is a major concern of surgeons, hospitals, and surgical facilities. Circumventing preventable complications is essential, and the pressure to avoid these complications during elective cosmetic surgery is especially important. Traditionally, nursing and anesthesia staff have managed patient positioning and most safety issues in the operating room. As the number of office-based procedures in the plastic surgeon's practice increases, understanding and implementation of patient safety guidelines by the plastic surgeon is of increasing importance.Key aspects of patient safety in the operating room include thoughtful patient positioning, ocular protection, proper handling of electrocautery, and airway management. If performed correctly with attention to certain anatomic landmarks, preoperative positioning of the patient can prevent nerve injury and postoperative joint or muscle pain. In this article we discuss proper patient positioning with attention to protection against nerve palsy. Further, we discuss common patient positions on the operative table and highlight special concerns associated with each position. Other safety issues including prevention of ocular injury and proper management of electrocautery are discussed.Responsibility of postoperative complications ultimately lies with the surgeon. Careful attention to patient safety guidelines is of paramount importance to surgeons, especially during elective cosmetic procedures. Attention to detail in patient positioning, eye protection, and bovie use can help avoid unnecessary perioperative complications and significantly improve the patient's cosmetic surgery experience.

Critical biomechanical and clinical insights concerning tissue protection when positioning patients in the operating room: A scoping review

“…Predicting risk for perioperative‐acquired PUs remains elusive 107 , 109 , 111 . Risk assessments alone have little predictive power, and clinical judgement is therefore very important.…”

Facial Cushioning during Prolonged Surgery in the Upper Torso

“…Safe patient positioning is a basic tenet of surgical preparation. Numerous publications describe the principles of protecting areas of the body that may be prone to injury from pressure or stretch [ 1 , 2 , 3 , 4 ]. Undoubtedly, many surgeons and anesthesiologists have developed their own modifications to accommodate for their particular needs and comfort, while maintaining the fundamental elements necessary to provide for a safe surgical environment.…”

Evaluation of Patient Safety Culture: A Survey of Clinicians in a Cardiovascular Operating Room

“…One reason for this concern is that physicians and surgeons have an obvious investment in the safety of their patients and what happens while in the OR due to the high-pressure, time-constrained, and technologically complex environment. 3 In recent years, patient safety reporting systems have developed throughout the health care system, and now, many hospitals are reporting information on ''near misses'' and sentinal events. Even with this type of reporting, an enhanced care delivery system must still be built to ensure that errors are prevented throughout hospitals.…”

“…Even with this type of reporting, an enhanced care delivery system must still be built to ensure that errors are prevented throughout hospitals. 3,4 To advance overall service, the health care system needs to implement a system that allows a way for health care professionals to obtain and communicate information related to the prevention of medical errors and improve the patient's safety and quality throughout the hospital and among all related health care professionals.…”