Safer Surgery part 38. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 344 Safer Surgery it to be labelled a PM situation there would not be an additional reminder about the intention. 4. The execution action putting the intention into practice is considered a separate phase in the model. It can contain specific errors . related to the ability to perform the intended task or meta-cognitive abilities to monitor the success of the intention implementation. 5. Finally the acting person must note whether or not the intention was fulfilled and if yes also to what extent. On occasion intentions are only partially fulfilled but seem to the acting person as though the task has already been completed. 6. Depending on the phase of the cycle in which this disturbance occurs different error types would be responsible for the failed execution of the intention as error form. Future research should aim to better understand the error types. We will use the framework introduced here to more closely analyse the examples presented at the start of the chapter. This will necessarily involve some assumptions and even speculations - as PM failures are related to intentions which can not be observed directly. Analysis of the Clinical Examples within the PM Framework Example 1 - Treatment in Time The situation where the anaesthesia team must remember the antibiotic can be classified as an event-based PM task. This case is particularly difficult because the intention should be fulfilled before another event skin cut takes place. Therefore the anaesthesia crew would need to create some kind of cue that could help them remember to provide the antibiotic before the skin cut. The skin cut is not an appropriate cue to trigger the action as it occurs too late. The newly created cue could be internal the crew could try to anticipate in detail the moment in which they want to remember to administer the drug. They could thus make their internal intention stronger so that they would be more alert about the beginning of the window of opportunity Gollwitzer and Schaal
