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PATIENT INVOLVEMENT
Should Patients Participate in Site Marking?
I
f you're not making your
PATIENT PARTICIPATION
patients active particiMarking should take place with
pants in your site-marking
the patient involved, awake
and aware, if possible.
process, you should be.
To what extent is a topic
for debate. Should they
verbally confirm the correct site, side and procedure, or draw the mark
themselves? Depends on
whom you ask.
The Ardmore (Okla.)
Regional Medical Center
asks patients to write their initials near the incision site followed by the surgeon
writing his initials near the incision site. Tara Flanagan, RN, Ardmore Regional's
clinical director, explains. "When we bring patients to the pre-op area, we have
them state their full name, DOB and the procedure to be performed. At this time we
have them mark the surgical site with a non-fading, one-time-use marker. When the
surgeon visits the patient before surgery, he then initials the patients' YES," says
Ms. Flanagan.
Similarly, patients at the Prairie Surgery Center in Springfield, Ill., mark their surgical sites with dots. "The surgeon then must mark the patients with his initials
before the patient is taken back to the OR," says Clinical Director Sarah Hilligoss,
RN, BSN. They follow the same formula at Clarkston (Mich.) Surgery Center,
except patients pre-mark their sites with an X before physicians confer with the
patients and mark sites with their initials, says Administrator Pam Simmons.
The patient should be involved in site marking if possible, but the attending surgeon should be the one to mark the site, says Margaret Sherman, RN, BSN, the
nursing director of the Hamilton (N.J.) Endoscopy & Surgery Center. "The patient
should verbalize the site upon entry into the OR and the time out should be performed immediately before incision by the whole surgical team, led by the RN using
the consent, the anesthetist at the armband and the surgeon at the surgical site,"
she says.
Two important distinctions: One, don't ask the patient to mark the right site.
Instead, ask the patient to mark the correct site. Using right or left can cause confusion. Two, be sure patients aren't sedated when you ask them to participate in
the marking process.
— Dan O'Connor
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