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O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U LY 2 0 1 5
1. Mark the site with a
marker that is suffi-
ciently permanent to
remain visible after
completion of the skin
prep. Keep a large bin
of one-time-use mark-
ers in the pre-op area.
To help preserve the
site marking, you might
want to dab the prep
solution where the surgeon has marked.
2. In addition to the prep, be mindful of the drapes. Position the mark so that it's vis-
ible after the patient is prepped and draped.
3. Make the mark at or near the incision site. Do not mark any non-operative site(s)
unless necessary for some other aspect of care. Adhesive site markers should not
be used as the sole means of marking the site.
4. Don't rely on patient reporting. Always visualize the mark in pre-op and compare
it to the orders and consent. The surgeon may have been to the bedside but failed
to mark or mark properly.
5. Communicate with staff and surgeons. Explain the why of site marking, and give
them real-life examples of wrong-site surgeries.
6. Make sure the time out is done consistently throughout the facility. Observe staff
and surgeons in the OR and procedure rooms to ensure site marking, and then
during the time out to confirm that all remain consistent with your policy and
process. Final verification of the site mark should take place during the time out.
7. Have everyone participate in the process. The surgeon, surgical team, nursing staff
ON YOUR MARK
10 Tips to Improve Site-Marking Practices
Pamela
Bevelhymer,
RN,
BSN
z YES OR NO? Does "X"
mean operate here, or
don't operate here?
That's why "X" should
never mark the spot.
