Surgical Safety Checklist Sop: Who Standards & Protocols

SURGICAL SAFETY CHECKLIST: STANDARD OPERATING PROCEDURE (SOP)

Document Control Number: [___________]
Facility Name: [________________________________________________]
Department: [________________________________________________]
Effective Date: [___________]
Revision Number: [___________]

1. PURPOSE

The purpose of this Standard Operating Procedure (SOP) is to mandate the implementation of the World Health Organization (WHO) Surgical Safety Checklist to reduce perioperative errors, minimize complications, and ensure consistent clinical standards across all surgical interventions within [Facility Name].

2. SCOPE

This protocol applies to all surgical personnel, including surgeons, anesthesiologists, nurses, and any medical staff involved in the perioperative care of patients scheduled for surgical procedures.

3. PROCEDURAL PHASES

PHASE I: SIGN IN (Before Induction of Anesthesia)

To be completed by at least one nurse and the anesthesiologist.

• Patient Identity Confirmed: [ ]
• Procedure/Site/Side Identified: [ ]
• Consent Obtained: [ ]
• Site Marked: [ ]
• Anesthesia Safety Check Completed: [ ]
• Pulse Oximeter on Patient and Functioning: [ ]
• Known Allergy Risk: [ ] (If yes, specify: [____________________])
• Airway/Aspiration Risk: [ ]
• Risk of >500ml Blood Loss (7ml/kg in children): [ ]

PHASE II: TIME OUT (Before Skin Incision)

To be completed by the entire surgical team.

• All Team Members Introduced: [ ]
• Confirm Patient/Procedure/Site: [ ]
• Prophylactic Antibiotics Administered (last 60 mins): [ ]
• Anticipated Critical Events (Surgeon): [________________________________]
• Anticipated Critical Events (Anesthesia): [________________________________]
• Anticipated Critical Events (Nursing): [________________________________]
• Imaging Displayed: [ ]

PHASE III: SIGN OUT (Before Patient Leaves Operating Room)

To be completed by the nurse, surgeon, and anesthesiologist.

• Name of Procedure Recorded: [________________________________]
• Instrument/Sponge/Needle Counts Accurate: [ ]
• Specimen Labeling (with Patient Name): [ ]
• Equipment Malfunctions Addressed: [ ]
• Post-operative Recovery Plan Discussed: [ ]

4. COMPLIANCE AND ACCOUNTABILITY

Strict adherence to this checklist is mandatory. Any deviation from these protocols must be documented in the patient’s medical record and reported to the Quality Assurance Department within [___] hours. Failure to execute these protocols may result in administrative review.

5. AUTHORIZATION AND SIGNATURES

Chief of Surgery: Signature: __________________________ Date: [___________] Printed Name: [________________________________]

Chief Nursing Officer: Signature: __________________________ Date: [___________] Printed Name: [________________________________]

Quality Assurance/Compliance Officer: Signature: __________________________ Date: [___________] Printed Name: [________________________________]

CONFIDENTIALITY NOTICE: This document contains sensitive clinical information. Unauthorized disclosure or reproduction is strictly prohibited by [Governing Statute/Regulatory Body Name].