Site marking

hi,

who is responsible for the actual site marking pre-operatively. does the floor nurse have to, or the or nurse, or the preop nurse...?

thanks

our preop/admissions nurses do it, the physician does it, or the floor nurse (if the pt is already inpt) will do site markings. of course, emergent cases are a different world. we have a 3 part form that has to be filled out (parts 1-2) before i do the preop interview. i finish and sign the last part after the time-out when the pt is in the room. the second part of the form actually documents who did the site marking, where the site mark is, who was present, etc. during the time-out the circulator checks the mark, the consent, x-rays, and signs the form.

Where I work, the nurse responsible for getting the pt ready, In Pt or Ambulatory Surgery, makes sure the site is marked.

If the pt is able, they acutally do the marking, using their initials, at, or as close to the site as possible. If they can't we ask the next of kin, the one signing the consent, to mark the site.

I'm not sure what others do, but we just use a good old fashion skin marking pen. Normally, it does not wash off during preps, cheap, whoops, I mean inexpensive to use, and easy to obtain for ED, and the floors.

We DO NOT use X, too often that's confused for "do not cut" so we use the pt's initials.

If the mark is made properly, you can still see it after draping, this helps during our pre incision time out.

Mike

Hi,

Who is responsible for the actual site marking pre-operatively. Does the floor nurse have to, or the OR nurse, or the preop nurse...?

Thanks

Our hospital has had patients marking their own correct sites for a little over a year. But as of this last week the policy has progressed to the person performing the procedure must mark the correct site. Of course the surgeons are looking for any way around this " hold up" in turnover time. The surgeons are having their office staff mark the patients prior to the patients arrival for surgery. The surgeon's PA is also allowed to mark the site.

Thanks all!

The physician performing the procedure only.

Don't know. But we on the floor do not do it.

Hi,

Who is responsible for the actual site marking pre-operatively. Does the floor nurse have to, or the OR nurse, or the preop nurse...?

Thanks

Hello Sharann,

at our facility, the patient marks the site with the surgeon's intials. once in the theatre we then have the patient verbally tell everyone in the room which side we are doing, i.e. right knee, right breast etc. the consent is also then shown to everyone in the room, scrub, ciruclator.

hope this is helpful, porsch65

Where I work, the physician performing the surgery (attendee or resident) marks the site with a 'yes'. Some will write their initials besides the 'yes' but as long as yes is written on the site that's all we care about. The nurse in Day Surgery has to document where the site was marked and by whom. We don't take the patient to OR until the marking is done (along with all the other protocol completed of course). Every now and then we get some resident who puts a 'x' on the site and whines when we ask to change it to 'yes'

but do you mark ears for ear tubes??

Our board of nursing has stated that it is not within a nurses scope of practice to mark the surgical site. Much to the surgeons' dismay. Actually, our docs have adjusted fairly well, but my sister (who works in a private hospital) says her docs still put up a fuss. And I noticed that a nurse marked my eyes when I got LASIK a few months ago. (yes, I called her on it).

We have the surgeon mark with their initials or "yes" preop, before entering the OR, and before the happy meds are given. Marking only needed when laterality or level such as spine an issue.

C

where I currently work, a university medical center, a physician is required to mark the site in preop. It's usually done by a resident, rarely by the attending. The policy is currently being revised, and will allow RNFAs to mark the site as well.

In the for-profit community hospital where I worked previously, the same day admissions nurse marked the site in preop.

As far as I know, the State Board here does not address this issue, and it is up to each hospital to make it's own policy.

but do you mark ears for ear tubes??

Where I work we mark the surgical site for every procedure. Our policy states that the only exception to the site marking is if surgery is being done on/in an orifice, ie., cysto. But our residents mark the abdomen, even for cysto. I guess they do that to avoid us 'nagging' on them.