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Risk factor for wrong-site surgery
Consistent site marking is critical. The method of marking and type of
mark should be consistent throughout your facility, safety experts say.
Nearly 9 out of 10 (88%) of our survey respondents say that their
marking methods and marks are standardized for all cases. That in
itself is good patient safety news, even if some surgeons are doodling
J's or ΒΈ's rather than YES or their initials.
"Marking operative sites should be performed in a consistent
manner throughout the [facility] so that everyone understands the
significance of an X or YES or NO or any other symbol that you use,"
says Godofredo Herzog, MD, an anesthesiologist and accreditation
consultant.
Many view deviating from a designated, standardized identifier for
the correct surgical site and allowing exceptions to the rule as an
invitation for wrong-site surgery to occur on your watch. Could even
a small deviation cause confusion? Well, consider this scenario. One
facility's routine is for the surgeon to mark the site with his initials
and the nurse to then mark it with an X. At the hospital across town,
however, they mark the non-operative limb with an X. Does X mark
the spot or not? Many say inadequate, inaccurate or ambiguous surgical site marking is a major risk factor for wrong-site surgery.
"Universal marking procedures should be just that: universal. An
agreed-upon convention amongst the professional societies is not just
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