TIMEOUT 1

You Need a Timeout
Vickie Bohuslar
HCA 375
Kristin Eeg
December 16, 2014

TIMEOUT 2
You Need a Timeout Wrong surgery site sounds hard to believe, but it happens. Wrong surgery site (WSS) includes surgery on the wrong side or site of the patient’s body, wrong procedure, or wrong patient. It also includes procedures that are invasive and pose more than a minimal risk to the patient. WSS have been the cause of unexpected death, or physical or psychological injuries know as a Sentinel Event (Mulloy DF, Hughes RG). So to prevent this, the Joint Commission has looked at the Universal Protocol of site marking and the Time Out Procedure. The two together along with patient participation provide a good defense to WSS. So everybody going into surgery needs a time out. Site marking comes first; the patient must be awake and family or legal guardian must be present. The mark is not an “X” it is marked by a team member with initials and yes at the operative site with a marker that will stay through the patient being prepped for surgery. If more than one procedure is scheduled all must be marked (Sigel J).As a patient make sure your surgeon marks the site not someone else. Then confirm the site right before the operation. IF you as a patient are too nervous make sure your family member or friend that is with you speaks up for you, train them to be your advocate (Cohen, E). The Time Out Procedure is one last time for a final assessment; right patient, right site or side, right position, right procedure and that all necessary documents, information, and anything needed for the procedure is present. Procedure cannot be done until the Time Out has been called. It is called by a team member. There must be verbal recognition of all the things listed above. If any team member believes that the procedure should not be done they
TIMEOUT 3 should speak now. But the provider that is performing the procedure has the final say (Sigel J). Now let’s look at this case: Mr. Smith was admitted to the hospital for surgery on his left knee. When Mr. Smith woke up from the anesthesia, he realized that his right knee had been operated on. You have been asked to form a team to analyze this wrong-site surgery. First we must make up our team to look into this case. Let’s start from the beginning and get a scheduler on our team. Then we need to have an anesthesiologist, a surgical tech, a nurse, a radiologist, a surgeon and someone from the legal department. With the team assembles let’s start from the beginning. When the patient was scheduled was the site stated, if so was it stated right. Did the anesthesiologist review the case before entering the operating room and was the site stated correctly? Where there x-rays of the correct knee available to the surgery team? And finally did anyone on the team realize the mistake that was being made and not speak up? These are the things the team will look at with each member looking in their area or expertise. When there is a problem