This Article Full Text (PDF) All Versions of this Article: 1553350609340895v1 16/3/249    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Goldberg, A. E. Articles by Urbach, D. R. PubMed PubMed Citation Articles by Goldberg, A. E. Articles by Urbach, D. R. Social Bookmarking                         What's this?

Attitudes of Patients and Care Providers Toward a Surgical Site Marking Policy

Division of Clinical Decision Making and Health Care, Toronto General Hospital

Julie L. Harnish, MS

Division of Clinical Decision Making and Health Care, Toronto General Hospital

Stacey Stegienko

Division of Clinical Decision Making and Health Care, Toronto General Hospital

David R. Urbach, MD, MSc

Departments of Surgery and Health Policy, Management, and Evaluation, University of Toronto, Ontario, Canada, david.urbach{at}uhn.on.ca

Background: In the fall of 2005, the University Health Network in Toronto, Canada, initiated a policy requiring the surgeon-or his or her delegate-to sign the incision site for all operations. Little is known about what health care providers and patients think about official surgical site marking policy. Method: Twenty-one patients and health care providers were interviewed, and the authors conducted field observations of surgeons while they marked their patients. The data were analyzed using grounded theory methods. Findings: Surgical site marking was perceived to be a safety precaution for operations involving multiple sides and structures but not for cases where there is no uncertainty about the intended operative site. Participants believed that marking could also facilitate error if the wrong side was marked. Site marking was perceived to have the effect of ensuring that the surgeon meets with the patient prior to the operation on the day of surgery. Concerns were raised with respect to who should mark patients and marking surgical sites for genital surgery or other private body sites. Conclusions: For operations that involve multiple possible surgical sites, site marking should be carried out by individuals who are knowledgeable about the patient and the proposed procedure. For operations in which there is no uncertainty about the intended site, interventions other than site marking could be implemented to ensure patient-surgeon interactions on the day of surgery. Surgical site marking procedures should respect patient dignity and privacy.

Key Words: wrong site surgery • site marking • Joint Commission • Universal Protocol • qualitative research

This version was published on September 1, 2009

Surgical Innovation, Vol. 16, No. 3, 249-257 (2009)
DOI: 10.1177/1553350609340895


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?