Outpatient Surgery Magazine

Marking Madness - April 2013 - Subscribe

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 44 of 157

OSM560-April_DIGITAL_Layout 1 4/5/13 2:28 PM Page 45 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 A P R I L 2 013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | 4 5

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