Universal Protocol - Typepad
|UNIVERSAL PROTOCOL | |
|Correct Site/Side Identification, | |
|Correct procedure, Correct Patient | |
|Verification Checklist | |
• Procedure may not commence until confirmation of all checklist tasks is complete.
• Indicate with Nurse's Initials when task completed.
PRE-OPERATIAVE (SDS OR IN PATIENT UNIT) VERIFICATION PROCESS
____ Patient identified by two identifiers.
____ Proposed site/side clearly identified on the scheduling form for Daily Scheduled Cases or Physicians Order for add-ons or emergencies.
SITE MARKING PROCESS
____ Consent forms verified by the pre-procedural nurse/(OR Holding Area/ Radiology/Cath Lab/ Nursing Units, etc.) If any discrepancies or uncertainties, the physician has clarified the discrepancies or uncertainties before the nurse initials.
____ Pre-procedural nurse in conjunction with patient/legal representative has marked procedural site/side with “Right” or “Left" (for cases involving laterality) using a skin marker. If multiple structures, such as fingers or toes is the procedure site, they will be marked as follows: “2 right” for the index finger on the right hand, etc. Levels of the spin will be marked as follows: cervical = CR, thoracic = TR, Lumber = LBR, Sacral = S
( Exempt from site marking
OCCURS IN OR/PROCEDURE ROOM
( NA ____ X-rays available.
( NA ____ Special equipment/implants available
( NA ____ Antibiotic given within 1 hour of procedure
____ "Time Out" called immediately before starting the procedure and includes:
____ (Time)
▪ Correct patient identity
▪ Agreement on the procedure to be done
▪ Correct side and site
▪ Correct patient position
▪ Availability of correct implants and any special equipment or special requirements.
| |Signature & Title |Initial |
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