Quality of Surgical Instruments

Srodon, P.D.; Briggs, Carol; Barry, Patricia L.; Steatham, J; Birch, Malcolm

doi:10.1308/003588406x98621

Cited by 21 publications

(13 citation statements)

References 2 publications

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“…In the United Kingdom, Daly et al reported on a pilot study of a Surgical Instruments Service to assess the quality of instruments purchased by the hospital, remove those unfit for purpose, and inform the manufacturer [2]. Brophy et al found that 15% of surgical instruments examined by medical and mechanical engineers failed to meet the appropriate British Standards (BS) guidelines [3]. Instruments purchased from certain manufacturers failed at a rate of 35%, suggesting that potentially one in every three instruments in some sets are of substandard quality [4].…”

Section: Introductionmentioning

confidence: 99%

Patient Safety Incidents Caused by Poor Quality Surgical Instruments

Dominguez¹,

Rocos²

2019

Cureus

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Objectives: Surgeons require high-quality surgical instruments to carry out successful procedures. Poor quality instruments may break intraoperatively leading to a failed procedure or causing harm to the patient. By examining the National Reporting and Learning Service (NRLS) database, the study aims to define the scale of the problem and provide evidence for the formation of surgical instrument quality control. Methods: The NRLS was searched from August 2004 - December 2010. The search revealed 2036 incidents, 250 of which were randomly selected and analyzed by a clinical reviewer. Results: One hundred and sixty-one incidents were identified causing five reoperations, one incident of severe harm, six incidents of moderate harm, 35 of low harm, and 119 no harm incidents. No patient deaths were discovered. Drillbits were the most commonly broken instrument. Conclusions: This report is likely to only be the tip of the iceberg. Poor reporting of patient safety incidents means that there may be as many as 1500 incidents a year of poor quality surgical instruments causing harm. We suggest that forming a Surgical Instrument Quality Service at Trusts within the National Health Service (NHS) could prevent harm coming to patients, reduce cost, and improve the outcomes of surgical procedures.

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Section: Introductionmentioning

confidence: 99%

Patient Safety Incidents Caused by Poor Quality Surgical Instruments

Dominguez¹,

Rocos²

2019

Cureus

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“…One risk reduction strategy was to ensure all surgical equipment was of highest possible quality. Quality control exercises highlight a strikingly high percentage of defective surgical instruments delivered to UK hospitals,26 and operating room incidents with potential to affect quality of care are most commonly equipment-related 27. Indeed, surgical environments are often busy and surgeons are rarely afforded time to optimise all possible variables prior to surgery, and even meticulous scrutiny will not eliminate risk.…”

Section: Discussionmentioning

confidence: 99%

The Only Eye Study (OnES): a qualitative study of surgeon experiences of only eye surgery and recommendations for patient safety

et al. 2019

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ObjectivePerforming surgery on patients with only one seeing-eye, where complications may result in catastrophic vision loss, presents unique challenges for the ophthalmic care team. There is currently no evidence regarding how surgeons augment their care when treating only eye patients and no guidelines for how these patients should be managed in hospital eye services. This study aimed to explore ophthalmic surgeons’ experiences of only eye surgery and perceptions of current practice.Design and participantsTen ophthalmic surgeons were asked to relate their experiences and views on performing only eye surgery in indepth, semistructured interviews. Interviews were audio-recorded and transcribed. Qualitative data were subjected to thematic analysis to identify key themes.SettingHospital eye service.ResultsFive key themes emerged relating to surgeons’ experiences and perceptions of only eye surgery: (1) differences in approach to consent, (2) strategies for risk reduction, (3) unmet training needs, (4) value of surgical mentor and (5) emotional impact of unsuccessful outcomes. Recommendations for improving the surgical journey for both the patient and the surgeon related primarily to better recognition and understanding of the complexities inherent with only eye surgery.ConclusionsOutcomes of only eye surgery may be improved through a number of methods, including development of purpose-designed training fellowships, adoption of stress-reducing strategies and enhancement of available support services. The findings identify emerging themes unique to only eye surgery and the need for guidelines on the provision of care for these high-stakes surgical patients.

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“…Various authors have suggested that the inferior quality of some surgical instruments may be a reflection of poor working conditions and low standards, particularly in the developing world. Responsibility lies with the suppliers from developed countries manufacturing in the developing world who behave in an unethical manner, maximising profits and minimising the remuneration of the people who actually produce the goods [ 9 - 11 ].…”

Section: Case Presentationmentioning

confidence: 99%

Dental root elevator embedded into a subgingival caries: a case report

et al. 2015

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BackgroundBreakage of surgical instruments is a rare complication. A mistake in operator technique or sub-standard/aged tools could lead to this type of accident. A tooth elevator is an instrument used in minor oral surgical procedures to luxate the tooth or fractured root from its socket. The authors have not found any previously published cases reporting the breakage of a tooth elevator tip which then remained as a foreign body in a hidden caries cavity.Case presentationA 28-year-old African black male was referred to a hospital in Tanzania for an intraoral radiography. The patient explained that six months previously his mandibular left third molar had been extracted. Whilst the healing process had been satisfactory, he had recently experienced acute oral pain in this region. The dental X-ray showed an image consistent with a piece of broken metal embedded in a distal subgingival caries at the mandibular left second molar.ConclusionOral and dental surgeons should take particular care when employing metal instruments with strong force in poorly visible areas. A radiographic study should be carried out when instrument breakage occurs. If an unexpected accident takes place during a surgical procedure, the patient must be informed in accordance with ethical codes, and suitable measures adopted to resolve the issue.

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Quality of Surgical Instruments

Cited by 21 publications

References 2 publications

Patient Safety Incidents Caused by Poor Quality Surgical Instruments

Patient Safety Incidents Caused by Poor Quality Surgical Instruments

The Only Eye Study (OnES): a qualitative study of surgeon experiences of only eye surgery and recommendations for patient safety

Dental root elevator embedded into a subgingival caries: a case report

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