On 20 January 2018, following a consultation with his patient, a certain Dr Blue decided to schedule an operation for 30 January. He contacted the pharmacy and the head OR nurse to check the availability of the appropriate sterile equipment. The pharmacist booked the equipment with the relevant manufacturers. On 30 January, the patient was brought into the OR. Dr Blue started the operation but in the middle of the procedure discovered that some of the required equipment was missing. A review of this adverse event highlighted two strands of analysis: the importance of organising work and relations between the OR’S various stakeholders; and the importance of implementing the World Health Organisation (WHO) checklist.
Date de parution : 06/2018
Thème : Medical tools
Mots clés : operating room, Procedure, organization, checklist
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