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Topic Outline
1. Surgical Safety background 2. Safety Surgical Checklist
Definition Benefits Content
Background
2008 Safe Surgery Saves Lives - Second Global Patient Safety Challenge.
Background
2011 International Patient Safety Goal (IPSG) IV
Ensure Correct-Site, CorrectProcedure, Correct-Patient Surgery.
Sign In
Time out
Sign out
THE SIGN IN
SIGN-IN PHASE
With patient
Identification Procedure and site marking Consent
Site Marking
Done in case of laterality (left or right distinction) Surgeon marks site with his initials Use of a permanent marker Done when the patient is awake and aware Documented in a form
SIGN-IN PHASE
Review with Anesthesia
Pulse oximeter functioning Blood loss Pre-anesthesia assessment Airway difficulty Allergy/ allergic reaction
TIME OUT
Each surgical team member introduces self by name and role Confirm and ensures
Correct patient Correct operation Correct site
TIME OUT
Surgeon Reviews:
Critical Steps Duration of Surgery Anticipated Blood Loss
Anesthesia Reviews:
Patient-Specific Concerns
TIME OUT
Prophylactic antibiotic Essential imaging
Orthopeadic, Neuro and Thoracic Surgeries
TIME OUT
Nursing Team Reviews:
Sterility should be verified Problems with Equipments and Other Preparations
SIGN OUT
Team confirms procedure performed
procedure may have changed or expanded during the operation.
SIGN OUT
Labeling of surgical specimen obtained
Equipment problems Issues that needs to be addressed PLANS and concerns re: post-operative management and recovery
Challenges
The operating room is a highly complex setting Time is of the essence Fast paced The traditional Hierarchal structure where the doctor is always right while nurse are sob servant followers
Action Steps
Empower nurses to assert and ensure compliance of the team Get the support and cooperation from the surgeons Consistency is the key!
References:
Pronovost, Peter , Joint Commission International: Safe Surgery Guide Institute for Healthcare Improvement World health Organization http://www.who.int/patientsafety/safesurgery/en/