Surgical Safety Checklist
Before induction of anaesthesia Before skin incision Before patient leaves operating room
(with at least nurse and anaesthetist) (with nurse, anaesthetist and surgeon) (with nurse, anaesthetist and surgeon)
Has the patient confirmed his/her Confirm all team members have Nurse Verbally Confirms:
identity, site, procedure, and consent? introduced themselves by name and role. The name of the procedure
Yes Completion of instrument, sponge
Confirm the patient’s name, and needle counts
Is the site marked? procedure, and where the incision will
be made. Specimen labelling (read specimen labels aloud,
Yes including patient name)
Not applicable Has antibiotic prophylaxis been given within Whether there are any equipment problems to
the last 60 minutes? be addressed
Is the anaesthesia machine and Yes
medication check complete? Not applicable
To Surgeon, Anaesthetist and Nurse:
Yes Anticipated Critical Events What are the key concerns for recovery
and management of this patient?
Is the pulse oximeter on the patient To Surgeon:
and functioning? What are the critical or non-routine steps?
How long will the case take?
What is the anticipated blood loss?
Yes
To Anaesthetist:
Does the patient have Are there any patient-specific concerns?
a: Known allergy?
To Nursing Team:
No Has sterility (including indicator results)
Yes been confirmed?
Are there equipment issues or any concerns?
Difficult airway or aspiration risk?
No
Yes, and equipment/assistance available
Risk of >500ml blood loss (7ml/kg in children)? Is essential imaging displayed?
No Yes
Yes, and two IVs/central access and Not applicable
fluids planned
This checklist is not intended to be comprehensive. Additions and modifications to fit local practice are encouraged.
Revised 1 / © WHO, 2009
2009