WHO Surgical Safety Checklist

The World Health Organization has issued the following Surgical Safety Checklist, revised in Jan. 2009. This checklist is not intended to be comprehensive. Additions and modifications to fit local practice are encouraged.

1. Before induction of anesthesia (with at least nurse and anesthesiologist)
Has the patient confirmed his/her identity, site, procedure and consent?
Yes

Is the site marked?
Yes
Not applicable

Is the anesthesia machine and medication check complete?
Yes

Is the pulse oximeter on the patient and functioning?
Yes

Does the patient have a:

Known allergy?
No
Yes

Difficult airway or aspiration risk?
No
Yes, and equipment/assistance available

Risk of >500ml blood loss (7ml/kg in children)?
No
Yes, and two IVs/central access and fluids are planned.

2. Before skin incision (with nurse, anesthesiologist and surgeon)
Confirm all team members have introduced themselves by name and role.

Confirm the patient’s name, procedure, and where the incision will be made.

Has antibiotic prophylaxis been given within the last 60 minutes?
Yes
Not applicable

Anticipated critical events
To Surgeon:
What are the critical or non-routine steps?
How long will the case take?
What is the anticipated blood loss?

To Anesthesiologist:
Are there any patient-specific concerns?

To Nursing Team:
Has sterility (including indicator results) been confirmed?
Are there equipment issues or any concerns?

Is essential imaging displayed?
Yes
Not applicable

3. Before patient leaves operating room (with nurse, anesthesiologist and surgeon)
Nurse verbally confirms:
The name of the procedure.
Completion of instrument, sponge and needle counts.
Specimen labeling. (Read specimen labels aloud, including patient name.)
Whether there are any equipment problems to be addressed.

To Surgeon, anesthesiologist and nurse:
What are the key concerns for recovery and management of this patient?

View the Surgical Safety Checklist (pdf).