Patient safety in vascular access surgery

Schwappach, D.; Widmer, M. K. (2015). Patient safety in vascular access surgery. Gefässchirurgie, 20(8), pp. 548-553. Springer-Medizin-Verlag 10.1007/s00772-015-0082-x

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Abstract
Background. Patients on hemodialysis who undergo vascular access surgery represent a vulnerable patient population and have an increased risk for suffering preventable adverse events due to multimorbidity and intense but fragmented health care involving multiple interfaces.
Objectives. Current developments and instruments for improving patient safety with emphasis on vascular access surgery.
Material and methods. Analysis and discussion of current patient safety data and instruments for improvement.
Results. Errors in non-operative management cause a considerable proportion of the adverse events. Checklists, preoperative site marking, surgical counting procedures and interprofessional team training are important instruments for patient safety in the operating room (OR). Standardization of postoperative handover using simple protocols can decrease the frequency of errors and patient harm. The safety climate in a department is an important factor which is essential for the effectiveness of safety tools.
Conclusion. Several effective instruments exist which improve patient safety in vascular access surgery. The consistent implementation and use of these instruments and an activesafety management, in particular at the interfaces between OR, ward care and outpatient care, can decrease adverse events. Interprofessional and interdisciplinary teamwork and involvement of patients are central resources for patient safety and should be intensified.

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