Ideas That Work: The OR's Closed Until Pre-Surgical Checklist is Complete

PAPERS IN ORDER? Patients don't leave pre-op until the pre-surgical checklist is complete and both nurses in the face-to-face handoff initial each item.

The OR's Closed Until Pre-Surgical Checklist is Complete

Given the chance, some surgeons seem to want to downplay the importance of surgical checklists. Some view the pre-op handoff/checklist as a waste of time, since a pre-incision/pre-surgical pause is performed in the OR. But why wait until the patient is on the table to discover an error? We make our checklists mandatory, beginning with the first phase and the pre-op face-to-face handoff. Our practice is to not allow our patients to leave the pre-op area until all components of the pre-surgical checklist are addressed and each item is initialed by both nurses participating in the face-to-face handoff. We used to hear, "Oh, I'll get the surgeon to sign that in the OR." But we decided that wasn't good enough. Surgeons may "protest" from time to time, but the practice makes everyone more diligent about making sure business is taken care of the way it should be. After all, we are our patients' advocates and it's our responsibility to make patient safety our highest priority.

Linda W. Frix, RN, BSN, CAPA
Northern Virginia Surgery Center
Fairfax, Va.
[email protected]