All surgical team members should participate in right-site, right-procedure, right-person time outs
Tomorrow, June 14, is National Time Out Day, and The Joint Commission (TJC) and the Association of periOperative Registered Nurses (AORN) are urging all surgical team members to participate in pre-operative time outs to prevent wrong site surgeries.
The day is part of the annual campaign to bring “renewed attention for everyone on the surgical team to pause before a surgical procedure begins to ensure it is the right site, right procedure and right person,” according to a joint statement from TJC and AORN.
TJC has long had a requirement for surgical teams to practice time outs under its Universal Protocol for Preventing Wrong Site, Wrong Procedure and Wrong Person Surgery™, which includes marking the procedure site under UP.01.02.01 and conducting time outs under UP.01.03.01.
TJC’s statement also includes suggested best practices from Haytham Kaafarani, MD, MPH, FACS, chief patient safety officer and medical director for TJC, to help ensure accurate, visible, and meaningful site markings:
- Mark the site clearly and as close to the actual site of surgery as possible. For example, a site marking for surgery on the fourth finger placed at the wrist to protect the surgical site opens the door for the wrong finger to be operated on. Instead, mark the actual surgical site at the finger — or, if not possible, mark the wrist but add an arrow to the fourth finger.
- Use radiographic imaging when site marking is not possible for non-visible organs. For example, surgery to the L4 of the spine cannot be marked. Good practice is to have the imaging in the OR and review it as a team to double and triple check surgical site accuracy prior to incision and during the procedure.
- Keep the site marking visible especially at key steps of the procedure, including the time out and at the time of incision. The site marking should not be intentionally or accidentally placed under the drape. Every member of the team should confirm the site marking is done, visible and appropriate – the time out provides an opportunity to recheck correct surgical site marking as a team.
More preoperative safety practices are available in Periop Today and on aorn.org, according to the joint statement.