Patient safety in operating theatres in Bangladesh
Abstract: Background Because of extreme population and a lack of resources the risk of beeing harmed while admitted to a hospital in Bangladesh is big. Mistakes made at operating theatres can result in devastating consequences, but by evaluating the patient safety that risk can be minimized. Right now Bangladesh is in the middle of an industrialisation that is contributing to the growing need for an expanding health care. The country is regularly suffering from cyclones, tsunamis and monsoon rains and there is an urgent demand for safe health care. Method The aim of this thesis was to study the physical structure, organisation and practice at operating theatres in Bangladesh. At three private and two public hospitals 14 operating rooms in total were visited and the basic equipment was examined. Managers, physicians, nurses and technicians were interviewed at all hospitals, 41 people in total participated in the study. Results The temperature control was not up to standard, bigger storages were needed and none of the public hospitals had enough washing equipment for proper scrubbing. Only one hospital could monitor the patient’s body temperature during surgery and proper resuscitation equipment was missing in half of the operating rooms. The autoclave process could not keep up with the surgeries and delays were not unusual. The cleaning staff had no training in patient safety and the staff found that the nurse’s education was not enough. The reporting of mistakes rarely reached the management and a written report was unusual. Discussion Most of the staff did not know what calibration meant and there were only biomedical departments at two of the hospitals. Even though training was re- quested by the staff the management did not plan for any changes. This shows that it is the organisation, not the human errors, that is the source to the unstable situation of health care. The lacking of the reporting system is an- other reason for the slow development. Staff with technical knowledge must be available at the hospitals in order to help prevent risks and all hospitals should establish a biomedical department. Patients had to lie on the floor, due to the shortness of space. This is not good for patient safety, but the alternative would be that they would end up with no help at all. The outcome of patient safety should always result in better health for the people. The personal had this view of thinking and they showed great engagement to their work. Key words: Patient safety, Bangladesh, operating theatres, operating rooms
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