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 |

| | | |

| | | |

| | | |

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download