Kerala enforces WHO-aligned surgical safety norms across hospitals

THe Kerala wellness section has issued a comprehensive operative refuge communications protocol aimed at preventing errors during procedures.The guidelines come in the wake of some alleged lapses reported in state-run hospitals that sparked a political controversy recently.According to an order dated April 15, the new guidelines mandate strict pre-operative verification, patient identification, and enhanced documentation to ensure patient safety across all healthcare institutions in the state.As part of the protocol, patients must be provided with wristbands containing surgery details, and the specific surgical site must be marked in advance to avoid wrong-site procedures.Phone calls and non-essential communications inside operation theatres (OTs) have been restricted to minimise distractions.As per the guidelines, doctors and nurses are required to complete patient details, including IP number and case records, prior to surgery.A pre-operative checklist must be filled and signed by the ward doctor and nurse-in-charge, and verified by the OT nursing officer before shifting the patient to the theatre.The protocol also mandates strict counting and documentation of surgical instruments and materials.Details must be recorded on a whiteboard before surgery, and counts must be rechecked post-procedure, with reports submitted to the concerned authorities.Emphasising patient involvement, the guidelines call for clear communication regarding procedures, risks, and benefits, along with separate consents for anaesthesia, surgery, and blood transfusion.Hospitals have also been directed to strengthen counselling systems and provide regular updates to patient relatives.To build a "culture of safety," the department has urged institutions to encourage error reporting without blame, ensure teamwork, and conduct periodic training and mock drills for OT staff.Measures to prevent retained foreign objects, equipment-related errors, and miscommunication have also been included, along with mandatory root cause analysis (RCA) of adverse events within 24 hours.The protocol aligns with global safety standards, including those of the World Health Organization (WHO), while incorporating context-specific improvements, officials said.Authorities have directed the Director of Medical Education and the Director of Health Services to ensure immediate implementation of the protocol across all institutions.The move aims to further strengthen Kerala's healthcare system, which is often regarded as a model for other states, by ensuring safe, standardised, and accountable surgical practices, the order added.