Surgical Time-Out

None

When a patient goes to surgery, their surgical team takes great care to provide a safe experience.
This involves a pre-procedural check-in, sign-in, time-out and sign-out.


Pre-Procedure Check-In:

Where- Pre-op room
Who- Patient and Pre-op Nurse
What- Verification of:

  • History and Physical
  • Consent
  • Nursing Assessment, including vital signs
  • Operative site marked by surgeon
  • Labs and images available
  • Blood products, special equipment available if needed

When- Before Patient is taken into OR


Sign-In:

Where- Pre-Op room
Who- Patient, OR nurse and Anesthesiologist or Certified Registered Nurse Anesthetist (CRNA)
What- Verification of:

  • Patient, Procedure, Site and Consent
  • Allergies, Airway Concerns and Aspiration Concerns
  • Risk of blood loss

When- Prior to giving anesthesia


Time-Out:

Where- Operating Room
Who- All members of the surgical team
What-

  • Surgeon introduces all team members
  • Verify patient, site and procedure
  • Verify patient images
  • Verify specific equipment available
  • Assess Fire Risk
  • Verify sterilization indicators for instruments
  • Verify antibiotics have been given
  • All members’ concerns addressed

When- Prior to skin incision


Sign-Out:

Where- Operating Room
Who- All members of the surgical team
What-

  • Procedure verified
  • OR RN confirms sponge, sharps and instrument count
  • Surgical specimens identified and labeled
  • Identify equipment concerns

When- Before Patient leaves OR


For patients undergoing breast surgery, common equipment needs include:                

  • Ultrasound
  • Machine to x-ray specimens
  • Geiger counter to look for radioactive lymph nodes or specimen
  • Specialized lighted retractors
  • Implants


The OR team works hard for their patients’ safety and follows the Joint Commission’s “Universal Protocol for preventing wrong site, wrong procedure and wrong person surgery”.
http://www.jointcommission.org/assets/1/18/UP_Poster.pdf