Final answer:
If a patient refuses marking, the correct procedure is to utilize a special purpose band with site and side specified, affixed to the patient's wrist. Marking the patient after they are asleep is unethical and violates their consent. Proper protocols, including the time out procedure and sign in confirmations, enhance surgical safety.
Step-by-step explanation:
The correct action to take if a patient refuses site marking for a surgical procedure is c) the surgeon utilizes a special purpose band, specifying side and site on the band and affixing it to the patient's wrist. This ensures proper patient safety measures are upheld while respecting the patient's autonomy. It is important to follow protocols that prevent wrong-site surgery, and having a marked band achieves this without going against the patient's wishes.
Marking the patient after they go to sleep (options a and b) would be unethical and against the principles of informed consent, which is a cornerstone of medical practice. The time out procedure before a skin incision emphasizes the importance of the entire team being aware of the surgical site and procedure. This includes verifying patient identity and the surgical site and procedure both during the sign in phase before anesthesia and again during the time out.
Additionally, it must be confirmed that prophylactic antibiotics have been administered within 60 minutes before the incision if indicated, and that all essential imaging for the correct patient is displayed in the operating room. Following these steps increases the safety of the surgical procedure and patient care post-operation.