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M A R K I N G
consistent marking convention is imperative," he says. "Expecting
them to remember what constitutes a properly marked site at each
facility is foolishness. And anyone saying that the site does not need
to be marked is in the wrong business."
Jack Egnatinsky, MD, an anesthesiologist and an accreditation surveyor for AAAHC, also stresses the importance of standardizing the
way you mark the site, be it with a YES or the surgeons' initials. "YES
at the site may work, but only if the other side is marked NO. An X is
not a good mark," says Dr. Egnatisnky. "And be sure that the site
marking is done with a marker that will withstand the surgical skin
preparation."
One facility manager in our survey says that different surgeons are
allowed to use different site-marking methods. Her ophthalmologist
places a dot above the operative eye, her orthopedic surgeon uses YES
and her general surgeon draws a line along the proposed incision.
"You have to empower your nurses to be consistent and hold surgeons accountable in the site marking for it to work on a consistent
basis," says Kelli Warden, BSN, RN, CNOR, director of surgical services at Southeastern Ohio Regional Medical Center in Cambridge, Ohio.
Be sure the mark is visible after the patient is prepped and draped.
Nearly half (46.3%) of those we surveyed say markings become less
visible after skin prep solution is applied around the planned incision
site. This presents a real danger, as surgeons may operate on non-
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