The AORN checklist is useful in all types of facilities, including hospital ORs, ambulatory surgery centers and physicians’ offices. “Open-ended questions are also included under the time out portion to encourage active participation from all members of the surgery team.” “It offers guidance for pre-procedure check-in, sign-in, time out and sign out,” says Groah. The AORN Comprehensive Surgical Checklist uses color codes to signify WHO and Joint Commission guidelines as well as areas where the two overlap. And AORN has created a Comprehensive Surgical Checklist that includes the safety checks outlined in the WHO Surgical Safety Checklist, while also meeting the safety checks within The Joint Commission’s Universal Protocol in order to meet accreditation requirements. In addition to the Joint Commission’s Universal Protocol, the World Health Organization (WHO) has created a 19-point Surgical Safety Checklist that also includes a surgery time out. But unlike in the aviation industry, surgeons and OR staff are not legally required to perform the surgery time out. The surgery time out is similar to the prescribed checklist that pilots and co-pilots are required to complete without interruption before a commercial airliner can take off. The surgeon should also address any questions or concerns members of the team may have at this time.” “This process not only covers the items on the checklist, but also includes all members of the team introducing themselves and the surgeon giving a brief description of the procedure. “When the designated team member - usually the circulating nurse or surgeon - calls for time out, the surgical team members must cease all their activities and give their full attention to the review of the surgery checklist,” says Groah. It involves the immediate members of the procedure team, which typically includes the individual performing the procedure, anesthesia providers, circulating nurse, operating room technician, and other active participants who will be participating in the procedure from the beginning. At this time, the entire surgical team pauses to confirm and agree that the appropriate surgery is about to be performed.Īccording to Groah, the surgery time out is conducted immediately before starting the invasive procedure or making the incision. The Universal Protocol is a standardized approach to eliminating wrong patient, wrong site and wrong procedures that includes pre-procedure verification, site marking and a surgery “time out” to confirm the surgical site, patient and procedure. This is the year when the Joint Commission’s Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery was first implemented. Even more disturbing is the fact that these 109 reported cases are more than double the 49 cases that were reported in 2004, according to Groah. However, many experts believe the actual numbers are much higher than this, since reporting is not mandatory in most states. The Joint Commission Center for Transforming Healthcare reports that “wrong patient, wrong site and wrong procedures” is the second most frequently reported sentinel event, with 109 such procedures reported in 2012. “And for surgical teams and healthcare administrators, a sentinel event of any kind is profoundly demoralizing to the spirit, as well as damaging to their reputation,” Groah adds.Īlthough wrong site surgery is a rare event, it remains a serious and preventable threat to patients in the OR that should never happen. “For patients and their loved ones, a wrong site or wrong side surgery or a wrong surgical procedure is life-changing,” says Linda Groah, MSN RN CNOR NEA-BC FAAN, the executive director and CEO of the Association of periOperative Registered Nurses (AORN). But mistakes in the OR can be especially devastating - not only for patients, but also for the hospital and OR staff.Īnd there are few OR mistakes as potentially devastating as wrong site surgeries. “Nobody’s perfect.” We’ve all heard this before, and most of us have used it at one time or another as an excuse for a mistake. Cover Story: Patient Safety and the Surgery Checklist
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