2.4.14 Operating theatre procedure: planning and control

Purpose and goal

Presentation of OR planning and process control in the OR (OR statute)

Process planning with operating theatre checklists and process pause for functional testing (team time out).

Criteria for the continuation of the process should be defined for important process sections. The fulfilment of the criteria should be checked schematically during a process pause (time out), e.g. before the start of an operation.

Economical use of operating theatre resources Avoidance of changes to the operating theatre plan (patient cancellations) Ensuring patient identity

Area of application

Central operating unit Wards with patients who are to be operated on

Description of the

Registration and preparation of a patient for surgery

Creation of the OP plan

The surgical plan is coordinated with anaesthesia and other operating departments by the senior physician of the department planning the operation. The process of coordination, procedures in the event of conflicting objectives and the type of publication of the operating theatre report must be clarified in the procedure. A time should be set when the operating theatre plan can be viewed on the wards that have registered patients for surgery. The procedure for revising the operating theatre plan must be regulated.

Retrieval and transport

Patients are called to the ward by the operating theatre staff if the remaining time required for the previous operation is foreseeable. Patients then receive the premedication prescribed by the anaesthetist on the ward and are transported by a registered nurse from the ward to the anteroom of the central operating theatre (usually lying in their bed). All medical records (medical charts and x-rays) must be handed over.

Infiltration

The procedure is described in a care standard

Identity protection

When taking over a patient (see flow chart), the persons taking over the patient introduce themselves personally and address the patient by name ("Hello, my name is..., you are Mr/Mrs... and are now to be operated on..."). At the same time, the medical records, the labelling of the bed or the patient (possibly a name bracelet) are checked for identity with the patient. If there is any doubt about the identity, the procedure must be stopped. The X-ray images are hung up on the display case in the operating theatre. Ensure that the sides are correct! The operating theatre field should be marked with an operating theatre marker. While the operating theatre is being prepared (skin disinfection, draping), the anaesthetist checks the "Operating theatre start checklist" in the course of the operation.

Check completeness before wound closure

See OP standard OPF 12

Handover to recovery room

OP completion

Documentation

OP process: see OPF13 OP report: 4.1.15 WHO checklist

Resources

Responsibilities Surgery report: Doctor Surgery procedure: Nursing Identity assurance: Anaesthesia

Notes and comments

Applicable documents

Literature, regulations

Aktionsbündnis Patientensicherheit Recommendations for action to avoid mix-ups in surgery, January 2006

Terms

Attachments

• Sample surgical procedure