![]() Situations where the side of pathology needs to be confirmed following examination under anaesthesia.Cases of bilateral simultaneous organ surgery.Operative procedures on teeth or mucous membranes.For digits on the hand and foot, the mark must extend to identify the correct specific digit.Ĭircumstances where site marking may not be appropriate include: When performing laparoscopic surgery, the side of the structure being treated must be indicated by a pre-operative mark on the skin, in proximity to the structure being operated on. The correct site for surgery must be confirmed by checking against the patient’s records, consent form, operating list and, when possible, verbally with the patient (or appropriate family members).Īn appropriate skin marker pen must be used and the mark must be an arrow that extends to near the incision site* and should remain visible after the application of theatre drapes. The site must be re-confirmed during the intra-operative ‘Time Out’ checks. Surgical marking should ideally be made by the operating surgeon, as part of the surgical check in the ward checklist. The pre-operative marking of a patient has a significant role in surgical safety, and can prevent wrong-site surgery. All consent forms should be checked, infection risk assessed, appropriate VTE prophylaxis prescribed and given, and baseline observations recorded.Nursing check – completed by a member of the nursing staff involved in the patient’s pre- and post-operative care The surgical check should confirm the patient identity, the intended operation, and site of the operation with the patient, with the site of operation markedįigure 1 – Example Nursing Checklist for Pre-Operative Management.Surgical check – requires the operating surgeon or a nominated deputy (who should be present in operating theatre throughout) to meet the patient on the ward prior to the operation.It provides initial checks for both operating staff and the ward nursing staff: Ward ChecklistĪ ward checklist should be completed prior to a patient’s operation. Many of these checks may not be feasible in emergency surgery, however checks should be completed where possible if they do not cause the patient any harm. In developed countries, nearly half of all adverse events in hospitalised patients are related to surgical care, and at least half of the cases in which surgery led to harm could be considered preventable. 1.1 Pre-Operative Surgical Site MarkingĮven though surgical procedures are intended to save lives, unsafe surgical care can cause substantial harm to patients (as described by the WHO Safe Surgery programme).
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