Take a “Time Out” in surgery
Kimberly Stover, R.N., B.S.N.
When you hear the term “time out” what comes to mind? Do you think of a brief stop in play called by a coach or team player in order to communicate with the team? Time-out periods in sports are often used to determine strategy and make sure all the players know what is expected of them in the upcoming plays. A time out also gives coaches a chance to draw their team together and unite. In hospitals, a time out can be used for similar purposes; most often, in surgery.
For surgical patients, a time out is called immediately prior to every surgical procedure. The operating room team (surgeon, anesthesia provider, circulating nurse and OR technician or scrub nurse) stops all activities to fully focus on communication about the patient. Time outs are called to make sure the surgical team is performing the right surgery on the right body part on the right person.
Similar to a checklist a pilot may use before initiating take-off to ensure passenger safety, a surgical time out is one final check to ensure patient safety. During a surgical time out, the team verifies the following:
• Patient name
• Patient date of birth
• Reading out loud the surgical consent form signed by the patient
• Kind of surgery to be performed
• Location and side of the patient where the surgery will be performed
• Correct position of the patient for the procedure
• Drug allergies
• Antibiotics given
• Proper equipment and implants are present
• Anticipation by the surgical team of any possible critical events
The surgical time out is one of three components of the Universal Protocol which has been endorsed by many healthcare provider organizations such as the American College of Surgeons, state hospital associations, and the Association of periOperative Registered Nurses. The surgical time out now also is included in the Surgical Safety Checklist developed by the World Health Organization and has been expanded for use by surgical teams to prompt important and timely dialogue on issues pertinent to the patient.
Perioperative nurses are committed to patient safety and are advocates for the time out to help reduce surgical error and improve optimal patient outcomes. The Association of periOperative Registered Nurses (AORN) annually promotes National Time Out Day to emphasize the importance of communication by surgical teams taking a time out before every surgical procedure. The 2010 National Time Out Day is June 16.
Copies of AORN’s comprehensive Surgical Checklist and Correct Site Surgical Tool Kit are available at the AORN website at aorn.org/NationalTimeOutDay. More information on the World Health Organization’s Surgical Safety Checklist can be found at who.int/patientsafety/safesurgery.
Kimberly Stover, R.N., B.S.N., is a surgical nurse and nurse educator in Flagstaff Medical Center’s Surgical Services Department.