WHO Surgical Safety Checklist. 2009

The Safe Surgery Saves Lives initiative was established by the World Alliance for Patient Safety as part of the World Health Organization’s efforts to reduce the number of surgical deaths across the world.

The aim of this initiative is to harness commitment and clinical will to address important safety issues, including inadequate anesthetic safety practices, avoidable surgical infection, and poor communication among team members. These have proved to be common, deadly and preventable problems in all countries and settings.

The Checklist is not a regulatory device or a component of official policy; it is intended as a tool for use by clinicians interested in improving the safety of their operations and reducing unnecessary surgical deaths and complications.

BEFORE INTRODUCTION OF ANAESTHESIA

SIGN IN

• Patient has confirmed
• Identity
• Site
• Procedure
• Consent
• Site Marked/Not Applicable
• Anesthesia safety check completed
• Pulse oximeter on patient and functioning

Does patient have a:

Known allergy?

• No
• Yes

Difficult airway/aspiration risk?

• No
• Yes, and equipment/assistance available

The risk of >500ml blood loss (7ml/kg in children)?

• No
• Yes, and adequate intravenous access and fluids planned

BEFORE SKIN INCISION

TIME OUT

• Confirm all team members have introduced themselves by name and role
• Surgeon, anesthesia professional and nurse verbally confirm
• Patient
• Site
• Procedure

Anticipated critical events

• Surgeon reviews: what are the critical or unexpected steps, operative duration, anticipated blood loss?
• Anesthesia team reviews: are there any patient-specific concerns?
• Nursing team reviews: has sterility (including indicator results) been confirmed? Are there equipment issues or any concerns?

Has antibiotic prophylaxis been given within the last 60 minutes?

• Yes
• Not applicable

Is essential imaging displayed?

• Yes
• Not applicable

BEFORE PATIENT LEAVES OPERATING ROOM

SIGN OUT

• Nurse verbally confirms with the team:
• The name of the procedure recorded
• That instrument, sponge and needle counts are correct (or not applicable)
• How the specimen is labeled (including patient name)
• Whether there are any equipment problems to be addressed
• Surgeon, anesthesia professional and nurse review the key concerns
• For recovery and management of this patient

Source: World Alliance For Patient Safety: Implementation Manual Surgical Safety Checklist. Safe Surgery Saves Lives.      http://www.who.int/patientsafety/safesurgery/checklist/en/