Interventions for reducing wrong‐site surgery and invasive clinical procedures

Background Specific clinical interventions are needed to reduce wrong‐site surgery, which is a rare but potentially disastrous clinical error. Risk factors contributing to wrong‐site surgery are variable and complex. The introduction of organisational and professional clinical strategies have a role in minimising wrong‐site surgery. Objectives To evaluate the effectiveness of organisational and professional interventions for reducing wrong‐site surgery (including wrong‐side, wrong‐procedure and wrong‐patient surgery), including non‐surgical invasive clinical procedures such as regional blocks, dermatological, obstetric and dental procedures and emergency surgical procedures not undertaken within the operating theatre. Search methods For this update, we searched the following electronic databases: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (January 2014), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2014), MEDLINE (June 2011 to January 2014), EMBASE (June 2011 to January 2014), CINAHL (June 2011 to January 2014), Dissertations and Theses (June 2011 to January 2014), African Index Medicus, Latin American and Caribbean Health Sciences database, Virtual Health Library, Pan American Health Organization Database and the World Health Organization Library Information System. Database searches were conducted in January 2014. Selection criteria We searched for randomised controlled trials (RCTs), non‐randomised controlled trials, controlled before‐after studies (CBAs) with at least two intervention and control sites, and interrupted‐time‐series (ITS) studies where the intervention time was clearly defined and there were at least three data points before and three after the intervention. We included two ITS studies that evaluated the effectiveness of organisational and professional interventions for reducing wrong‐site surgery, including wrong‐side and wrong‐procedure surgery. Participants included all healthcare professionals providing care to surgical patients; studies where patients were involved to avoid the incorrect procedures or studies with interventions addressed to healthcare managers, administrators, stakeholders or health insurers. Data collection and analysis Two review authors independently assesses the quality and ed data of all eligible studies using a standardised data extraction form, modified from the Cochrane EPOC checklists. We contacted study authors for additional infor