SURGICAL SAFETY CHECK LIST

 THEATER BRIEFING
 SIGN IN
 TIME OUT
 SIGN OUT
THEATER BRIEFING

 THEATRETEAM MUST DISCUSS THE

OPERATION LIST BEFOR STARTING THE
OPERATIOS.
SIGN IN
NURSE CHECKS THE PATIENT

 Surgical Ward Nurse:

 Escorts the patient to the Operation Theatre
and handing over the patient to the theatre
nurse.
 Does your patient and relatives knows what
kind of surgery he is undergoing?
– In case of doubt Ask question and clarify with
appropriate authority.
The checks must be performed
 by nurse before sending the patient is :
 Right Patient.
– Check name, age, sex, diagnosis, registration no.
admission date etc.
 Type of Operation: ie hernia, appendectomy, etc…
 Routine investigation required for operation ie.
ECG, CBC, Chest X ray, blood urea, Serum
creatine, blood group cross match..etc..
 The checks must be performed
 Written consent for anesthesia and operation.
 Must check whether patient is examined by anesthetist
and surgeon, any allergies, medication, or chronic
illness,
 Physical procedures ie hair care, bathing, enema,
 Operation site preparation and marking. Shaving and
wrapping surgical site.
 Vital sign check up and compares with previous data.
Inform for unusual or alteration in vital sings.
 Pre op medication orders.
IMMEDIATELY BEFORE
INDUCTION / ANESTHESIA

 What is your role ?

ANESTHETIST performs the check on

 Written consent for anesthesia and operation both

signed by patient or relatives.
 Surgical site marking,
 Ward checks completed.
 Allergies and pre operative medication, check list
completed.
 Anesthesia equipment check completed
 Team members check on additional medical
equipment required for surgery
TIME OUT

 Surgeon, anesthetist, scrubbed nurse check

the consent and surgical site.
 Discuss the operation steps in brief:
Time out
 Anesthetists: Introduce the patient, General
Condition, any points that cause patients lif in
danger, decision on anesthesia druds, doses, etc.
 Surgeon:
 Review the whole case for changes in operative
decision, steps and unusual symptom.
 Scrubbed nurse: checks the availability of
instruments gauze and pads, mops, on the trolley,
 Circulatory nurse: checks for all medical equipments
are ready to use and make sure that everything is in
order.
Time out

 Confirm that:
 all medication is ready to give,
 All images are displayed or seen.
 Are there any new team members? Does he
know the rules and polices procedure in
operatin theatre.
SIGN OUT
 After completion of surgery:
 Circulatory nurse performs the check on:
 Confirms swab, instrument and needle counts are
correct.
 Confirms all specimens taken during the surgery are
labeled correctly.
 Any equipment failures or issues that should be
addressed,
 Surgeon, anesthetist, nurse review the post operative plan