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Elements of the Surgical Safety Checklist

Sign in
Before induction of anaesthesia, members of the team (at least the nurse and an anaesthesia professional) orally confirm that:

The patient has verified his or her identity, the surgical site and procedure, and consent.
The surgical site is marked or site marking is not applicable.
The pulse oximeter is on the patient and functioning.
All members of the team are aware of whether the patient has a known allergy.
The patient’s airway and risk of aspiration have been evaluated and appropriate equipment and assistance are available
If there is a risk of blood loss of at least 500 ml (or 7 ml/kg of body weight, in children), appropriate access and fluids are available

Time out
Before skin incision, the entire team (nurses, surgeons, anaesthesia professionals, and any others participating in the care
of the patient) orally:

Confirms that all team members have been introduced by name and role.
Confirms the patient’s identity, surgical site, and procedure.
Reviews the anticipated critical events.
Surgeon reviews critical and unexpected steps, operative duration, and anticipated blood loss.
Anaesthesia staff review concerns specific to the patient.
Nursing staff review confirmation of sterility, equipment availability, and other concerns.
Confirms that prophylactic antibiotics have been administered =60 min before incision is made or that antibiotics are not indicated.
Confirms that all essential imaging results for the correct patient are displayed in the operating room.

Sign out
Before the patient leaves the operating room:

Nurse reviews items aloud with the team.
Name of the procedure as recorded.
That the needle, sponge, and instrument counts are complete (or not applicable).
That the specimen (if any) is correctly labelled, including with the patient’s name.
Whether there are any issues with equipment to be addressed.
The surgeon, nurse, and anaesthesia professional review aloud the key concerns for the recovery and care of the patient.

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