Ensuring correct site surgery

AORN Journal,  Nov, 2002  by Rita C. Scheidt

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Table 1
SAMPLE PATIENT SAFETY CHECKLIST

                                   Anesthesia
Preoperative area            RN   care provider   Surgeon

* Verify that the            X          X            X
patient's informed
consent describes
the surgical site
and laterality, as
appropriate.

* Verbally confirm           X          X            X
the surgical site
and laterality with
the patient and
family members.

* Review the medical         X          X            X
record for consis-
tency in identifying
the correct surgical
site.

* Have patient or            X
family member
mark the surgical
site with an indelible
marking pen as
close as possible
to the surgical
incision.

                                  Scrub     Anesthesia
Intraoperative area          RN   person   care provider   Surgeon

* Confirm patient            X      X            X
identity, consent,
surgical procedure,
and laterality before
transfer to the OR bed.

* Review the medical         X                                X
record for consistency
in identifying the correct
surgical site.

* Review imaging             X                                X
studies and confirm
surgical site.

* Require surgical           X      X            X            X
team timeout
immediately before
the incision or start
of the procedure for
final confirmation of
the surgical site.

NOTES

(1.) Institute of Medicine, To Err is Human: Building a Safer Health System (Washington, DC: National Academy Press, 2000).

(2). Code of Ethics for Nurses with Interpretive Statements (Washington, DC: American Nurses Publishing, 2001) Also available at http://www.nursingworld.org/ethics/chcode.htm (accessed 15 July 2002).

(3.) "Risk management skills help reduce surgery on the wrong operative site," Healthcare Risk Manager 3 (Fall 1999) 2-3.

(4.) Joint Commission on Accreditation of Healthcare Organizations "A follow-up review of wrong site surgery," in Sentinel Event Alert, no 24, http: //www.jcaho.org/about+us/news+letters/sentinel+event+alert/sea_24.htm (accessed 25 July 2002).

(5.) Joint Commission on Accreditation of Healthcare Organizations "A follow-up review of wrong site surgery."

(6.) Joint Commission on Accreditation of Healthcare Organizations, "Lessons learned: Wrong site surgery," Sentinel Event Alert, no 6, http://www.jcaho.org/about+us/news+letters/sentinel+event+alert/sea_6.htm (accessed 25 July 2002); ECRI, "Operating room risk management," Sentinel Event Alert, no 6. Also available at http://www.jcaho.org/about+us/news+letters/sentinel+event+alert/sea_6.htm (accessed 25 July 2002); "AORN position statement on correct site surgery," in Standards, Recommended Practices, and Guidelines, in press.

(7.) Joint Commission on Accreditation of Healthcare Organizations, "Lessons learned: Wrong site surgery"; "AORN position statement on correct site surgery."

(8.) "AORN position statement on correct site surgery."

(9.) Ibid.

(10.) Joint Commission on Accreditation of Healthcare Organizations, "Lessons learned: Wrong site surgery"; "AORN position statement on correct site surgery."