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Implementation of a Surgical Safety Check List

Cyber-Sight Nurse Education Course (Modified for lecture use by Heather Machin, RN). Implementation of a Surgical Safety Check List. At the end of this presentation you should know:. < The components of the check list < Who is responsible for implementation parts of the checklist

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Implementation of a Surgical Safety Check List

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  1. Cyber-Sight Nurse Education Course (Modified for lecture use by Heather Machin, RN) Implementation of a Surgical Safety Check List

  2. At the end of this presentation you should know: < The components of the check list < Who is responsible for implementation parts of the checklist < Potential points of conflict and how to avoid and/ or resolve them < How to use the checklist < Value to be derived from use of the checklist

  3. 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.

  4. 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

  5. A set of Safety Checks has been assembled to reduce the number and severity of adverse events involving: • Surgeons • Anesthesiologists • Nurses • Public health experts

  6. 3 Components of the Check • Sign In • Time Out • Sign Out

  7. Components of the Checklist 1 Sign in As the patient enters the room and before induction of anesthesia • Patient identity confirmed • Site marked • Anesthesia safety check • Allergy • Airway and pulse oximeter if general anesthesia • Prosthesis and surgical needs

  8. Components of the Checklist 2 Time out Before the start of surgical intervention • Identify/introduce team • Team verbally confirms patient site, procedures/ allergy • Surgeon/review critical steps • Anesthesia/concerns? • Nurse/sterility and special instruments, sutures, medicines

  9. 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

  10. 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?

  11. Quiz • Sign in, time out, and sign out are the major components of the checklist? T F • You don’t have to check allergies before surgery? T F • Who is responsible for the safe surgery check?

  12. Questions Heather Machin, RN ORBIS International Heather.machin@orbis.org

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