Surgical Time-Out
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”.
