TRUE TO FORM Connie Swarzen, BSN, RN, and Jamie Doyle, MD, make sure the i's are dotted and t's are crossed before bringing a patient back for surgery.

PRE-OP PAPERWORK
A Passport to Surgery

We created a pre-surgical passport for pre-op staff giving handoff reports to OR nurses and anesthesia providers.

In the passport's first column, we note specific tasks that need to be completed before patients are brought back for surgery: required lab tests and forms, special physician orders and marking of the surgical site, for example.

Once tasks are complete, a member of the pre-op staff initials the corresponding row in the second column. Whoever brings the patient back for surgery can get an update of the patient's status with a quick glance at the form. If pre-op nurses checked that the H&P was complete, the circulating nurse and CRNA know they don't have to do the same.

We color-code similar tasks and group them together to make the form easier to use. We included hard stops in the form's yellow and red sections. If those tasks aren't complete — the surgeon didn't sign the surgical site, for example — if the patient can't go back to the OR.

Hold everyone accountable by having the pre-op nurse, the circulator and the anesthesia provider sign the form to verify that they've read and completed it.

Shelley Smith, RN
Carolinas Healthcare System
Charlotte, N.C.
[email protected]