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Non-technical Aspects of Safe Surgical Performance

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Patient Safety in Surgery

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Abstract

Successful operative surgery requires completion of the operative sequence, with its tasks and steps accompanied by the requisite dexterity and technical ability. However these technical attributes need to be accompanied by good choices, effective judgement and sound decisions. Such actions can be either enhanced or possibly undermined by concurrent events taking place within the environment of the operating room. Extrinsic or intrinsic factors can influence the thinking and the behaviours of the individual surgeon in either a positive or a negative fashion. Being aware of these influences and understanding their implication requires a language and ability to analyse, which to date, has been an elusive element of surgical practice.

Non-technical skills, and those other elements that constitute human factors, are increasingly appreciated as being important items which underpin good surgical performance and can influence the outcomes of any operative procedure.

This chapter itemises some of the events and circumstances which may directly or indirectly manipulate the performance of the surgeon and attempts to relate them to a non-technical skills taxonomy, – NOTSS (non-technical skills for surgeons) and in doing so, point to tips or heuristics which may protect or mitigate against the unwelcome limitations imposed upon surgical ability and performance.

Additionally, adverse events such as aggressive and rude behaviours, distractions, fatigue and stress, automaticity invited by routine and repetitive tasks,-all of which lead to lead to error prone circumstances, – these human factors are discussed, as are controlling measures.

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Authors and Affiliations

  1. Department of Paediatric Surgery, Royal Aberdeen Children’s Hospital, University of Aberdeen, Foresterhill Road, Aberdeen, AB 25 2ZG, Scotland, UK

    George G. Youngson CBE, MBChB, PhD, FRCPEdin, FRCS

Authors
  1. George G. Youngson CBE, MBChB, PhD, FRCPEdin, FRCS
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Correspondence to George G. Youngson CBE, MBChB, PhD, FRCPEdin, FRCS .

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Editors and Affiliations

  1. Department of Orthopaedics, Denver Health Medical Center, Denver, Colorado, USA

    Philip F. Stahel

  2. Department of Orthopaedics, Denver Health Medical Center, Denver, Colorado, USA

    Cyril Mauffrey

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Youngson, G.G. (2014). Non-technical Aspects of Safe Surgical Performance. In: Stahel, P., Mauffrey, C. (eds) Patient Safety in Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4369-7_7

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  • DOI: https://doi.org/10.1007/978-1-4471-4369-7_7

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  • Online ISBN: 978-1-4471-4369-7

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