Navigate to...

Overview
Complete
Repair surgery for right Achilles tendon
WHO Surgical Safety Checklist
Inspection score
90.91%
Failed items
0
Created actions
0
Type of Surgery:
Repair surgery for right Achilles tendon
Date/Time of Surgery:

4th Jul, 2019

1:09 PM +08

Nursing Team:
Nurse Florence
Anaesthetist:
Dr Helen D’Troy
Surgeon:
Dr Patrick Luz
Location:
1775 Park Blvd Palo Alto, CA 94306 United States (37.43110128178846, -122.1502390234537)
Before induction of anaesthesia
85.71%
(with at least nurse and anaesthetist)
Has the patient confirmed his/her identity, site, procedure, and consent?
Yes
Is the site marked?
Yes
Is the anaesthesia machine and medication check complete?
Yes
Is the pulse oximeter on the patient and functioning?
Yes
Does the patient have a:
Known allergy?
Yes
Notes
Allergy to latex. We prepared the latex-free operating room.
Difficult airway or aspiration risk?
Yes, and equipment/assistance available
Risk of >500ml blood loss (7ml/kg in children)?
No
Before skin incision
100%
(with nurse, anaesthetist and surgeon)
Confirm all team members have introduced themselves by name and role
Yes
Confirm the patient's name, procedure, and where the incision will be made
Yes
Had antibiotic prophylaxis have been given within the last 60 minutes?
Yes
Anticipated Critical Events
100%
To Surgeon:

What are the critical or non-routine steps?

List critical or non-routine steps
Prepared the latex-free operating room.

How long will the case take?

Include estimated time
30 mins to 1 hour

What is the anticipated blood loss?

Include blood loss estimate
Less than 500 ml
To Anaesthetist:
Are there any patient specific concerns?
No
To Nursing Team:
Has sterility (including indicator results) been confirmed?
Yes
Are there equipment issues or any concerns?
No
Is essential imaging displayed?
Yes
Before patient leaves operating room
80%
(with nurse, anaesthetist, and surgeon)
Nurse Verbally Confirms:
The name of the procedure
Yes
Completion of instrument, sponge, and needle counts
Yes
Specimen labelling (read specimen labels aloud, including patient name)
Yes
Whether there are any equipment problems to be addressed
No
To Surgeon, Anaesthetist, and Nurse:
Are there any key concerns for recovery and management of this patient?
Yes
List concerns
Medical team is aware that there should be no latex around the patient.
Surgeon name and signature
Dr Patrick Luz
4th Jul, 2019 1:17 PM +08