Importance of side marking in opthalmic surgery

Background: in 2003 the National Patient Safety Agency (NPSA) advised side marking for avoiding errors and reducing incorrect side surgery. This survey aimed to ascertain whether or not, these 'best practice' guidelines are currently being implemented by ophthalmic surgeons in Scotland and, if not, the reasons for this, and also to ascertain surgeons' attitudes towards marking. Methods: Semi-structured interviews with ophthalmic surgeons throughout Scotland, either face to face or by telephone, on their current practices and attitudes relating to preventing wrong side surgery. Results: Non-compliance with side marking was described by 48% of the surgeons, which includes both consultants and specialist registrars. This survey reveals incomplete implementation of this policy in ophthalmic surgery for a number of reasons. The most common was bypassing the established multi-step process of checks, which risks an increased likelihood of surgical errors. Conclusion: Guidelines are not consistently being implemented in their entirety by eye surgeons in Scotland. In order to improve compliance and improve patient safety, we suggest a risk-stratified approach in side marking based on individual patient factors that may encourage wider acceptance, without compromising patient safety.