Ethics, errors and education in surgical operating room

Abstract

Patient safety errors in OR may originate from: surgeon
on account of forgetfulness, inattention, poor
motivation, carelessness, negligence and recklessness;
Hospital system due to understaffing, inadequate
equipment, fatigue, time pressure and
inexperience.Quality surgical training is crucial for
creation of surgical workforce for health care delivery.
The surgical trainees during ‘Junior Residency’ need
training in both ‘Surgical’ and ‘Communication’ OR skill.
The surgical skill learnt in OR is: competence in ‘basic
surgical techniques’; skill of ‘assistance and minor
surgeries’: hernia repair, appendectomy, skin grafting
and laparoscopic skills. During‘Senior Residency’
independent surgicaljudgment and performance of
advanced surgical procedures to gain extensive
operating experience.The non‐surgical skill that
promotes patient safety in OR are ‘communication
skill’ and ‘team skill’.The ’supervised progressive
responsibility model of surgical training’ has elements
embedded for patient safety. Surgical trainer promotes
trainee’s skill and ensures patient safety as well the
highest quality of surgery, through gradual decreasing
levels of supervision in OR, namely Direct Supervision
where the trainer is physically present;Indirect
supervision where the trainer becomes available within
few minutes; oversight where after the surgery review
is providedwith feedback and progress monitoring
where progress is monitored and supervision is done
only in complex surgeries. Supervised surgical training
helps creation of skilled practicing surgeon and ensures
patient safety.