Sue Swaim

CMHS OR Time Out Audit

Wrong-patient, wrong-site, wrong-procedure events can and must be prevented. Implementing evidence-based, risk-prevention strategies for the identification and verification of the correct patient, surgical site, and procedure will reduce the risk of error

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Title Page

Document No.
Audit Title
Client / Site
Conducted on
Prepared by
Location
Personnel

Time out is conducted prior to skin Incision or introduction of scope?
All other activities are suspended (except in case of life-threatening emergency) during the time out?
During time out the procedure is identified, correct laterality if applicable is identified, and patient consent is verbalized?
Surgical Site is marked and visible ( if applicable)?
Relevant images properly labeled and displayed?
Checked implants are readily available?
Verbalized dry time for skin antiseptic has occurred (3 min.)?
Antibiotic prophylaxis ordered and started before incision?

Sue Swaim

CMHS OR Time Out Audit

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Print as PDF

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