Stop & Wait a Minute
What are the components of a pre-procedure time out?
Correct Patient
Correct Site(s)
Correct Procedure
What type of surgical procedures that must have site markings?
Left vs Right
Fingers, Toes, Kidneys
Spinal Levels
If you have to reposition and redrape a patient for a 2nd procedure what should be completed?
A 2nd time-out.
It is ok to read the procedure from the white board during time-out?
True or False
False
The procedure including laterality should be read from the consent.
When should Time Outs be completed?
*Prior to leaving pre-procedure area
*Entering the procedure room
*When responsibility of care is transferred
What is included in proper site marking?
Surgeons Initials on/near surgical site
Who is involved in the pre-procedure time-out in the OR?
RN
ST
Anesthesia
If during the pre-incision time out the site marking is not visible, what should occur?
STOP THE LINE.
The site should be reverified prior to incision.
What are examples of patient identifiers?
Patient Name
DOB
MRN
When should the site not be marked?
When the patient refuses marking.
When the infant is premature (<37 weeks).
When it is Technically / Anatomically impossible - mucosa/perineum.
When the sites are Obvious- lacerations/burns/abscesses.
Sites that are not pre-determined (ports).
When surgery is midline, no intended laterality or single organ - liver biopsy; circumcision; c-section
When is a Pre-Incision Time Out Completed?
After the patient is positioned, prepped, draped, and cords thrown off.
What should be included in the pre-incision time out?
patient name, DOB, procedure, laterality, antibiotics, implants needed available, fire risk, and code status
Who should be involved in pre-op Verification?
Pre-Op RN
Circulating RN
If a patient refuses site marking or site is unable to be marked (technically/anatomically impossible/premature/teeth) what should be done next?
A wristband should be applied to identify the correct laterality/organ.
If there is music playing, talking, and movement in the OR while completing the time-out for incision - what should be completed?
Stop Time-Out process and address issues then re-start.
During the debrief, what should be included?
Procedure name, surgical count (correct/incorrect), specimens received (number/name/type), surgical/equipment problems if applicable, expected post-op needs, wound classification.
What are reasons to STOP THE LINE in Pre-Op?
Inconsistencies in procedure and site on consent or patient confirmation.
What should be included on wristband for site verification?
Patient's Name
DOB
Site of procedure
Practitioner Initials
If the Time-Out is completed prior to local being given and the surgeon leaves the room and immediately returns, it is ok to proceed with draping and incision.
True or False
False
A second time should be completed if the surgeon leaves the room after the initial time-out is completed.
If all members of the surgical team did not confirm / agree with the time out, what should occur next?
STOP THE LINE - the procedure should not start until all members agree.