which everyone felt
empowered to speak
up if they had any
problems or concerns
— a culture where
speaking up is always
right. We reinforced
this message with a
lot of coaching and
instruction at our unit
meetings.
We now perform a brief and debrief in the operating room. It
includes the entire team. We perform the brief before we anesthetize
the patient. We do the debrief before the surgeon leaves the room. We
found this had a significant impact in developing an inclusive team
feeling.
The circulator prompts the anesthesiologist who takes the lead on
the brief. The patient is still awake. Everyone is introduced. We verify
the procedure to be done. We also confirm that all the needed equip-
ment is there and available for use. We verify allergies and antibiotics.
The surgeon takes the lead on the debrief, prompted again by the cir-
culator. We talk about what specimens are taken and how they should
be handled, labeled and stored, and we review the surgical procedure
that was performed. This is also a time we discuss any concerns with
the flow of the procedure and what went well and what didn't go well.
Of course, we make sure all our counts are finished.
2. Preview what you'll do,
review what you did
A P R I L 2 0 1 8 • O U T PA T I E N TS U R G E R Y. N E T • 3 7
• FORGET SOMETHING? The near-miss occurred while the surgeon was closing
and the nurses were counting.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
