Taking a time out before surgery is enough to ensure the right procedure is performed at the right location and on the right patient. To emphasize the importance of this essential element of safe surgical care, the Association of periOperative Registered Nurses (AORN) created National Time Out Day, which highlights The Joint Commission's Universal Protocol for Preventing Wrong Site, Wrong Procedure and Wrong Person Surgery. National Time Out Day falls on Wed., June 8 this year.
A joint statement issued by AORN and The Joint Commission says it's estimated that wrong-site surgeries take place "with depressing regularity" — about five times a day. "We can reverse this trend and work toward a day when wrong site surgeries never happen," notes the statement. "To get there, patients and their advocates, and surgical teams and their administrators, need to work together to reduce the risk of this catastrophic event."
The focus of this year's National Time Out Day awareness campaign is to encourage surgical teams to make sure they're dedicating enough time for time outs. "AORN has heard from members concerned that time outs are being conducted hastily, likely as a result of surgical teams working through a backlog of operations postponed by the pandemic," says the statement. "There has been a significant uptick in wrong-site surgeries in the last three years, so it's time to recommit to fully engaging in the time out process."
AORN and The Joint Commission recommend facilities audit their time out practices by determining if the process is being led by a designated leader, whether all team members are engaged for the process and if all other activities are halted. The findings should be discussed with all team members in a constructive way and improvements should be developed if warranted. Those proposed fixes should be tested to make sure they are feasible over the long haul. Finally, all surgical teams should have a time out champion for each procedure.
To make it easier for perioperative teams to comply with The Joint Commission's time out protocol and to meet World Health Organization standards, AORN created a comprehensive surgical checklist, which individual facilities can customize according to their specialties and specific needs.
"Making time for time outs is critical to ensuring safe surgery for every patient, every time," says AORN Executive Director/CEO Linda Groah, MSN, RN, CNOR, NEA-BC, FAAN. To hear more about ways to implement effective time outs from The Joint Commission and Ms. Groah, listen to this episode of the Periop Talk podcast.
Some facilities have devised novel approaches to time out awareness over the years and shared their creative ideas in the pages of Outpatient Surgery Magazine. Barbara Harvey, RN, an OR circulator at Fredericksburg (Va.) ASC, used a kazoo to grab the attention of her OR teams when the time out was set to begin. "Believe me, it works, and it thoroughly entertained the nurses, techs and some of the surgeons," she says.
St. John Macomb-Oakland Hospital in Warren, Mich., upped the ante from a kazoo to a gong. "The vibrations of a gong are supposed to clear the mind and connect the energy of the people in the room," says nurses Erica A. Brenckle, RN, BSN, HNB-BC, and Delia Gealer, RN, BSN, HNB-BC. "That's why hanging a Tibetan gong in each of our cath labs was the perfect way to set the tone for a proper time out before every procedure," they add. "When the recorder strikes the wall-mounted gong, it commands your attention and sets the intention, and it creates a sort of Pavlovian response to be mindful, engaged and focused on patient safety."Adam Taylor and Joe Paone