Implementation of a Surgical Safety Check List

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Implementation of a Surgical Safety Check List

• Cyber-Sight Nurse Education Course
• (Modified for lecture use by Heather Machin, RN)

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At the end of this presentation you should know

• lt The components of the check list
• lt Who is responsible for implementation parts
  of the checklist
• lt Potential points of conflict and how to
  avoid and/ or resolve them
• lt How to use the checklist
• lt Value to be derived from use of the
  checklist

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Why this checklist in the operating room?
In order for a surgical procedure to be completed
successfully a team must work together to ensure
that all of the required components are accounted
for and working.
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Safe Site Surgery will help the surgical team to
avoid

• Surgical deaths and errors
• The adverse legal issues
• Surgical infection
• Poor communication among surgical team members

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A set of Safety Checks has been assembled to
reduce the number and severity of adverse events
involving

• Surgeons
• Anesthesiologists
• Nurses
• Public health experts

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3 Components of the Check

• Sign In
• Time Out
• Sign Out

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Components of the Checklist 1

• Patient identity confirmed
• Site marked
• Anesthesia safety check
• Allergy
• Airway and pulse oximeter if general anesthesia
• Prosthesis and surgical needs

• Sign in
• As the patient enters the room and before
  induction of anesthesia

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Components of the Checklist 2

• Identify/introduce team
• Team verbally confirms patient site, procedures/
  allergy
• Surgeon/review critical steps
• Anesthesia/concerns?
• Nurse/sterility and special instruments, sutures,
  medicines

• Time out
• Before the start of surgical intervention

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Components of the Checklist 3

• Sign out
• To be completed before the patient leaves the
  operating room

• Documentation
• Surgical instrument and sponges account
• Specimen (if any) labeled
• Equipment problems?
• Review any concerns for recovery
• Team reviews key concerns

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Some important considerations for the nurse

• Is the patient fasting (Nil Per Oral NPO)?
  When did the patient eat last?
• Is the necessary imaging displayed?
• Are the surgical items that you have pulled
  what the surgeon needs? Do you need to check with
  the surgeon first?
• Is the patient situated on the table without
  unnecessary pressure that could cause nerve
  damage? How long will the procedure take?
• Are all members of the team ready to start?

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Quiz

• Sign in, time out, and sign out are the major
  components of the checklist? T F
• You dont have to check allergies before surgery?
  T F
• Who is responsible for the safe surgery check?

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Questions

• Heather Machin, RN
• ORBIS International
• Heather.machin_at_orbis.org