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Preventing Errors and Infections During Surgery: Steps for Hospital Staff and Patients

Rerun image You have been admitted to the hospital for surgery. You and your family or friends may have many feelings, like anxiety or nervousness, about the surgery. Rest assured that the hospital staff has standards in place to ensure that your stay during surgery is a safe one.
Hospitals follow safety and quality measures that are set by government organizations, researchers, and expert panels. These measures require hospitals to:
  • Adopt safety techniques and procedures
  • Report on how well they are implementing these procedures
  • Regularly train hospital staff
Here are some measures that the hospital staff will take to prevent surgical errors and infection during your hospital stay and surgery.

What the Hospital Staff Will Do to Prevent...

Patient Identification Errors

Receiving the correct surgery and care means making sure that your doctors, nurses, and others on your healthcare team know who you are. This means having your correct name, telephone number, and other unique identification on record. Hospitals have standards to:
  • Identify each patient with the treatment or service intended for him or her
  • Match the treatment or service to the specific patient
One way the hospital staff will enforce these standards is by using at least two forms of patient identifiers. Having at least two forms when giving medicines, collecting blood samples, and performing surgery will decrease the chance of mistakes in patient care.

Procedure Errors

Along with correct patient identifiers, the hospital staff will make sure that all important information is collected prior to your surgery. This is called preprocedure verification. During this time, they will make sure that all information and equipment needed for your surgery are available. They will also make sure that the information and equipment are correctly matched to your patient identifiers and that they have reviewed the information among themselves and with you.
Doing surgery on the wrong part of the body can be a terrible mistake. Your surgical team will take careful actions to mark the specific site on your body where surgery will be done.

Infection

Hospitals have also adopted many standard procedures to help prevent infection during surgery. You may notice many of these techniques during your stay. If you are concerned about a technique to prevent infection, speak up. Ask your doctor about how they will prevent infection. Regular and thorough hand washing by hospital staff is one of the most important aspects of infection prevention.
The hospital staff will do the following to help prevent infection:
  • Have a specially trained and dedicated infection control staff
  • Regularly educate all surgeons and staff on infection control measures
  • Vaccinate and treat personnel for exposure to infection at all times
  • Implement computer-assisted decision support and reminders that help doctors know when and how much antibiotic or other medicine to give you
Many hospitals also have a program to identify patients who harbor dangerous bacteria, such as methicillin-resistant staph infection (MRSA), prior to surgery.
Your healthcare team will do the following before, during, and after your surgery:
Before Surgery
  • Treat any other infections you have, such as urinary tract infections, if able
  • Perform a "surgical scrubbing" of the arms and forearms
  • Use an antiseptic on your skin
  • Remove hair from your body only if needed and in the most sterile manner (such as clipping or using depilatory cream)
  • Give you prophylactic antibiotics within 1-2 hours
During Surgery
  • Wear special gowns, masks, gloves, and hair covers that act as a barrier to microorganisms
  • Keep the surgical area sterile or "free of germs" by using special sterile drapes and other antimicrobial barriers
  • Limit the number of people coming into and out of the operating room
  • Keep the operating room at a comfortable temperature (eg, 68°F to 73°F [20°C to 22.7°C]) to prevent infection
  • Keep the surgery time as short as possible
After Surgery
  • Discontinue antibiotics within 24-48 hours after surgery
  • Control your blood sugar levels
  • Control bleeding
  • Minimize catheter use and duration
  • Keep the main wound covered with sterile dressing for 24-48 hours
  • Discontinue IVs as soon as possible
  • Use sterile techniques when handling tools and changing wound dressings or catheters, such as:
    • Wash hands
    • Wear a mask
    • Unfold supplies in an ordered manner on a sterile surface
    • Carefully put on gloves

Other Steps You Can Take

The hospital staff will follow strict guidelines so that your surgery and hospital stay are successful. However, there are things you can do to lower your risk of infection. Lifestyle factors, such as smoking, can actually increase your risk of infection. Consider these good habits and lifestyle changes:
  • Wash your hands often and make sure visitors do, too. You may consider using an antibacterial wash.
  • Stay warm before your procedure.
  • Make sure your healthcare providers are washing their hands and wearing gloves and masks.
  • Use tissues, or cough and sneeze into the bend of your elbow.
  • Maintain a healthy weight.
  • Eat a nutritious, healthy diet.
  • Keep blood sugar levels under control.
  • Quit smoking.
  • Use clean techniques around your surgical wound:
    • Do not let others touch you near your surgical wound.
    • Follow your doctor's instructions for using a sterile technique and special kits for your post-surgical needs.
Your doctor may also ask you to bathe with a special soap before surgery. Do not shave the area near where you will have surgery. This can irritate the skin.
Tell your healthcare team right away if you have any signs of an infection, like redness, swelling, pain, fevers, or chills.
Together, you and your healthcare team can ensure that your hospital stay and surgery is a safe one.

RESOURCES

Centers for Disease Control and Prevention http://www.cdc.gov/

The Joint Commission http://www.jointcommission.org/

CANADIAN RESOURCES

Canadian Medical Association http://www.cma.ca/

Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

References

Association of Perioperative Registered Nurses. Perioperative standards and recommended practices—2009 edition. Listserv, University of Vermont website. Available at: http://list.uvm.edu/cgi-bin/wa?A2=ind0907c&L=MEDLIB-L&P=5553. Published June 2009. Accessed December 19, 2011.

Centers for Disease Control and Prevention. Infection control in healthcare settings. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dhqp/. Accessed December 29, 2009.

DynaMed Editorial Team. Surgical wound infection prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Last updated December 14, 2009. Accessed December 31, 2009.

The Joint Commission. Accreditation program: hospital national patient safety goals. The Joint Commission website. Available at: http://www.jointcommission.org/NR/rdonlyres/868C9E07-037F-433D-8858-0D5FAA4322F2/0/RevisedChapter%5FHAP%5FNPSG%5F20090924.pdf. Created 2009. Accessed January 25, 2010

The Joint Commission. Infection control. The Joint Commission website. Available at: http://www.jointcommission.org/PatientSafety/InfectionControl/. Accessed December 29, 2009.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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