Securing the circuit of a sample collected in the operating room

What is it about?

The circuit taken by a sample collected in the operating theatre is a complex process involving a large number of steps that, combined with multiple locations and players, makes it a high-risk process.

Any system failure could lead to missing results and disruption in the continuity of care. These failures may thus delay a diagnosis of therapeutic management, or even require a repeat procedure in the case of an essential sample.

This Patient Safety Solution is intended to secure the circuit taken by a sample collected in the operating theatre, focusing on the pre- and post-analytical steps in the sample circuit, which are responsible for the majority of adverse events reported.

This Patient Safety Solution is intended for operating theatre teams and all professionals involved in sample management.

Method

The proposed Patient Safety Solution was drafted by a work group of experts : surgeons, anatomo-cytopathologists, biologists and operating theatre health executives, based on the lessons learned from the in-depth analysis of 599 adverse events occurring in the context of samples collected in the operating theatre and declared in the accreditation system feedback database from 2008 to 2016 by surgeons members of the following accreditation body: the French urology association (AFU), orthopaedic and trauma surgery (Orthorisq) and reconstructive and cosmetic plastic surgery (Plastirisq).

Moreover, a literature search has been conducted by the approved accreditation body.

Risk reduction tools

The adverse events in-depth analysis allowed identification of causes and circumstances of adverse events related to the sample circuit and propose a prerequisite and a list of essential elements intended to question organisational and professional practices and to determine the actions required to improve the safety of the sample circuit on preoperative, peroperative and postoperative phases, and product transport. Moreover, implementation assistance documents are proposed.