Just recently my OR did a trial run for a universal checklist.
My OR took a checklist from a leading hospital and tweaked it to serve our hospitals' purposes.
It seems that there is a bunch of push-backs from both sides of the place (surgeons & Rns).
I would like to know if your OR uses them and how did you guys use them? ie how did you implement the checklist?
If you just started the checklist, how did your OR handle the roll out.
Thanks in advance!
Nov 7, '10
Are you talking about a checklist of things that need to be done to the patient or put in their chart prior to coming up to surgery by the unit nursing staff?
There should be no option givin. This is a fairly standard care tool across the country. Your management should just put the policy in place and be done with it, either your unit nurses do the checklist or they get written up. If I am not mistaken, I am pretty sure it is one of the small things that joint comision always looks for in a patients chart up in surgery preop. Checklist, up to date H&P, consent. Checklist needs to be signed by 3 different people typically, the unit nurse/outpatient surgery nurse, the preop/holding room nurse, the circulating nurse. There is a checklist like this in use within the 3 major systems and small surgery centers/hospitals in San Antonio, where I live.
Nov 8, '10
The check list that came out has 5 columns.
The 1st column is for pre-op
2 - 4 is for the OR nurse with a checkbox that states 'lock the stretcher before moving the pt over' and 'did anesthesia put a pulse ox on the patient.
the 5th is for PACU
Nov 9, '10
We've been using one for almost a year now. On the front is an area for either the floor or admitting RN's to fill out, the surgeon, anesthesia, and the holding area RN. Under that is an area for a pre-block time-out. Under that is a large STOP sign. Patient is not to proceed to the OR without everything checked off, signed, dated, and timed.
The back of the sheet contains the actual pre-procedure time-out and another short checklist for before leaving the OR (after the procedure is done) and for signing the patient over to PACU.
There was a lot of complaining when we rolled these out but it had to be done. Now everyone is used to doing them and it's just part of our daily routine.
Nov 9, '10
We used to have checklists in my facility. It has gone by the wayside, and I think that is a shame.
The OR checklist helps to ensure that the patient receives thorough and cohesive care despite all of the necessary hand-offs. Now that the there is no checklist, there is no accountability. Decent circulators pick up the slack from preop and holding. There are other circulators who just don't care enough to do that and the patient is the one who suffers.
Nov 9, '10
This almost sounds more like a PI monitoring tool than a true checklist. We have lots of those to do- each person has to do quite a few each month here. A "checklist" to me would include things like consents signed, universal protocol, labs done, type & cross done, things like that. Anesthesia using a pulse ox and locking the bed? Not so much. We use an SBAR sheet that doesn't become part of the permanent record- preop checks off if all ordered labs were drawn, if results are back, pre-op antibiotic given or needs given. OR has spots for type of dressing, if antibiotics were redosed, any issues that occured. PACU has spots for pain level, fluids, additional meds given.
Nov 10, '10
It's still in the tweaking phase...
Did your 'universal' (that's what we are calling it) checklist have a N/A box,
cuz an issue came up, one of the checkboxes is did the pt verbalize their name, DOB, etc... But it was a NICU baby and in my hospital they go straight to the OR room from their room accompanied by security and the RN. We wanted an N/A box beside just so that we can have that on the sheet.
Nov 10, '10
We have electronic documentation for that, and one of the options is "guardian/ repsonsible party" for those on vents or too young. We also have an option for "other" which we use on vented patients with no family, so we confirm ID with the nurse from the unit. There's also a check box that this was "deferred due to emergent status" used mostly for traumas who come in as John/Jane Doe.
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