Surgery and theatre safety

Question 1

What are the different ward check lists that should be completed prior to an operation commencing?

Answer 1

• Surgical check
• Nursing check

Question 2

Describe a surgical check?

Answer 2

• Surgeon meet the patient on the ward before the operation
• Confirm patient identity, intended operation and the operation site
• The site of operation should be marked by the surgeon

Question 3

Describe a nursing check?

Answer 3

• Consent forms checked
• Infection risk assessed
• VTE prophylaxis prescribed and given
• Baseline observations recorded

Question 4

Describe pre-operative surgical site marking?

Answer 4

• Should be made by operating surgeon
• Confirm site using patient records, consent form, operating list
• Mark site with an arrow extending near to the site
  
  • Should not touch the incision site => will result in tattooing
  • Should remain visible after drapes attached

Question 5

Describe the benefits of the WHO surgical checklist?

Answer 5

• Reduces rate of major post-op complications and mortality
• Should be complicated for all surgical interventions

Question 6

Describe the components of the WHO surgical safety checklist?

Answer 6

• 3 sections:
  
  • Sign in - completed before induction in presence of anaesthetist
  • Time out - completed before first incision, final identification of patient/procedure
  • Sign out - completed prior to key members of operating team leaving

Question 7

Describe some techniques of infection control during surgery?

Answer 7

• Ensure sterile surgical equipment
• Effective scrubbing up technique
• Empirical prophylactin antibiotics if indicated
• Adherence to intra-operative infection control measures

Question 8

When do NICE recommend the use of prophylactic antibiotics in surgery?

Answer 8

• Clean surgery involving prosthesis/implant
• Clean-contaminated surgery
• Contaminated surgery