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Who Surgical Safety Checklist: Before Induction of Anesthesia Before Skin Incision Before Patient Leaves Operating Room

This document outlines a surgical safety checklist used by a hospital nursing division. The checklist is divided into three sections to be completed before induction of anesthesia, before skin incision, and before the patient leaves the operating room. Each section includes verification of patient identity and procedure, equipment checks, confirmation of antibiotic administration, and anticipating of critical events or issues that could arise. The goal is to promote safety and communication among the surgical team.

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0% found this document useful (0 votes)
93 views1 page

Who Surgical Safety Checklist: Before Induction of Anesthesia Before Skin Incision Before Patient Leaves Operating Room

This document outlines a surgical safety checklist used by a hospital nursing division. The checklist is divided into three sections to be completed before induction of anesthesia, before skin incision, and before the patient leaves the operating room. Each section includes verification of patient identity and procedure, equipment checks, confirmation of antibiotic administration, and anticipating of critical events or issues that could arise. The goal is to promote safety and communication among the surgical team.

Uploaded by

Rpgmc Dr-nicu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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NURSING DIVISION

WHO SURGICAL SAFETY CHECKLIST


BEFORE INDUCTION OF ANESTHESIA BEFORE SKIN INCISION BEFORE PATIENT LEAVES OPERATING ROOM

(with at least nurse and anesthesiologist) (with nurse, anesthesiologist, and surgeon) (with nurse, anesthesiologist, and surgeon)

Has the patient confirmed his/her identity,  Confirm all team members have Nurse Verbally Confirms:
site, procedure, and consent? introduced themselves by name and role.  The name of the procedure
 Yes  Completion of instrument, sponge and
 Confirm the patient’s name, procedure, needle counts
Is the site marked? and where the incision will be made.  Specimen labelling (read specimen labels
 Yes aloud, including patient name)
 Not applicable Has antibiotic prophylaxis been given within the  Whether there are any equipment
last 60 minutes? problems to be addressed
Is the anaesthesia machine and medication check  Yes
complete?  Not applicable To Surgeon, Anaesthetist and Nurse:
 Yes  What are the key concerns for recovery and
Anticipated Critical Events management of this patient?
Is the pulse oximeter on the patient and To Surgeon:
functioning?  What are the critical or non-routine steps?
 Yes  How long will the case take?
 What is the anticipated blood loss?
Does the patient have a:
Known allergy? To Anaesthetist:
 No Are there any patient-specific concerns?
 Yes
Difficult airway or aspiration risk? To Nursing Team:
 No  Has sterility (including indicator results)
 Yes, and equipment/assistance available been confirmed?
Risk of >500ml blood loss (7ml/kg in children)?  Are there equipment issues or any concerns?
 No
 Yes, and two IVs/central access and fluids Is essential imaging displayed?
planned Yes
Not applicable

SURGEON ANESTHESIOLOGIST SCRUB NURSE CIRCULATING NURSE

Last Name First Name Middle Name

Attending Physician Age Date of Birth Gender Room / Bed

Date PIN Hospital Case No

DON FORM 19-11

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