Final answer:
Prior to patient removal to PACU, a checklist is followed which includes team introductions, confirming patient details, reviewing critical steps and concerns, confirming antibiotic administration, checking essential imaging, performing a time out before the incision, and reviewing surgical counts and equipment.
Step-by-step explanation:
Prior to patient removal to the Post-Anesthesia Care Unit (PACU), there are several critical steps that are performed to ensure the safety and well-being of the patient. The checklist approach borrowed from aviation is applied in the operating room to facilitate this process.
Pre-Removal Checklist:
- Team members, including the surgeon, nurse, and anesthesia professional, introduce themselves, confirm the patient's identity, the surgical site, and the procedure to be performed.
- The surgeon discusses any critical or unexpected steps, the operative duration, and anticipated blood loss. Anesthesia staff address concerns particular to the patient, and nursing staff confirm sterility, equipment availability, and other concerns.
- Administration of prophylactic antibiotics within 60 minutes before the incision or confirmation that antibiotics are not indicated is assured.
- Essential imaging results are available and displayed in the operating room.
- Prior to anesthesia induction, there is a verbal confirmation of the patient's identity, the proper functioning of the pulse oximeter, known allergies, and the patient's airway and risk of aspiration are evaluated.
- Before the skin incision, a time out is taken by the entire medical team to orally confirm the surgical checklist.
- The nurse reviews aloud if the procedures are correctly recorded, if the needle, sponge, and instrument counts are complete, if any specimen is correctly labeled, and if there are any equipment issues.
The aim of these steps is to ensure patient safety by preventing errors and ensuring all team members are aware of the critical information related to the patient's care.