Title Page
-
Document No.
-
Name of patient
-
Name of surgeon
-
Name of nursing staff
-
Name of procedure
-
Conducted on
-
Audit Title
-
Registration no of patient
sign in ( before incision)
1.Identity
-
Identity of patient confirmed by a member of operating team
-
the name of patient on identity band matched to case sheet & OT List
2.Lateralisation
-
the incision is marked
-
The identity band on side of incision or target organ
3.Antibiotic
-
the antibiotic has been given on OT table
4.Conscent
-
Routine
-
Special
5.Count
-
Gauges
-
Sponges
-
Instruments
-
Time
sign out ( before closure)
Count
-
Gauges
-
Sponges
-
Instruments
-
count complete
-
Time
-
Add signature
