teamwork errors

teamwork errors

Operating theatres have been described as ‘among the most - complex political, social and cultural structures that exist, full of ritual, drama, hierarchy and too often conflict’. In such an environment, systems should seek to prevent error by improving workplace preparedness and by incorporating defences that reduce human error or minimise its consequence. Well - recognised and potential errors include: /uni25CF the wrong patient in the operating theatre; - /uni25CF surgery performed on the wrong side or site; /uni25CF the wrong procedure performed; /uni25CF failure to communicate changes in the patient’s condition; /uni25CF disagreements about proceeding; /uni25CF retained instruments or swabs ( Figure 15.2 ) . All these events are catastrophic for the patient and almost invariably occur through a lack of communication (see Never events ). This means that all thea tre sta ff should follow proto - cols and be familiar with the underlying principles supporting a uniform approach to caring for patients.