Let each department help create and implement the checklist, she
says. Enlist the help of surgeons, anesthesiologists and nurses to
make sure you've covered all aspects of patient care, including wound
classification, confirming sterilization indicators, establishing a sharps
safe zone before each case and all phases of antibiotic administration,
from pre-op to just before the first incision is made. Anesthesia
looked at steps that addressed airway concerns and availability of
equipment, blood loss, medication checks, status of the pulse
oximeter, the type of anesthesia to be administered and fire risk
assessment. It also added a time out before the administration of
anesthesia.
If you're thinking that some of these steps may not seem like patient
safety issues, you're not alone. Saint Peter's debated whether each
aspect needed to be in the checklist.
"At first we weren't sure that a sharps safe zone check needed to be
in the checklist since we usually consider this a staff safety issue,"
says Roseann DiBrienza, MS, RN, NE-BC, director of perioperative
services. "But if a nurse or surgeon suffers a sharps injury, then it
absolutely can affect patient safety."
The checklist is divided into 4 parts:
• Pre-procedure check-in. The circulating nurse confirms patient
information and both the RN and the anesthesiologist assess the
patient for anesthesia concerns.
• Prior to anesthesia induction. The circulating nurse confirms
patient information with the anesthesiologist and makes sure all risks
are accounted for before the patient is induced.
• Prior to incision. The circulating nurse confirms with the surgeon
and anesthesiologist that all surgical team members are present for
surgery and the appropriate antibiotic has been administered before
the surgical incision is made.
J U N E 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 9 3
