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Surgery and Theatre

Complete the WHO surgical safety checklist

Available to

Theatre nurses, anaesthetists, surgeons.

The WHO checklist has three phases. Each phase must be completed before the next step of the case can happen: it cannot be skipped or edited afterwards.

The three phases

PhaseWhenWhat it unlocks
Sign InPre-op, before induction of anaesthesia.Enter Theatre.
Time OutIn theatre, before skin incision.Record Incision.
Sign OutIn theatre, before the patient leaves the room.To Recovery.

Complete a phase

  1. Open the case and select Safety Checklist.
  2. Tick each item of the current phase as the team confirms it. Items that do not apply have their own not applicable tick (site marking, antibiotic prophylaxis, essential imaging, specimen).
  3. Select Complete Sign In, Complete Time Out or Complete Sign Out. Your name and the time are recorded.
The checklist at the start of Sign In: eight items and the Complete Sign In button.
The checklist at the start of Sign In: eight items and the Complete Sign In button.

Checklist items

PhaseItems
Sign InPatient confirmed identity, site, procedure and consent; surgical site marked; consent verified in the record; anaesthesia machine and medication check; pulse oximeter functioning; known allergies reviewed; difficult airway / aspiration risk assessed; blood loss risk assessed.
Time OutAll team members introduced; surgeon, anaesthetist and nurse confirm patient, site and procedure; antibiotic prophylaxis within the last 60 minutes; anticipated critical events reviewed; essential imaging displayed.
Sign OutName of the procedure recorded; instrument, sponge and needle counts correct; specimen labelled; equipment problems addressed; key concerns for recovery reviewed.

Rules

  • Every item must be ticked (or marked not applicable) before the phase can be completed.
  • Sign In is completed while the case is Pre-op; Time Out and Sign Out while it is In theatre.
  • Sign Out needs the incision time to be recorded and a Count Witness who is a different person from you.
  • A completed phase is a signed record and cannot be changed.
A case in theatre: Sign In and Time Out are complete and recorded with name and time.
A case in theatre: Sign In and Time Out are complete and recorded with name and time.

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