Surgical Safety Checklist

Complete for every surgical procedure.

  • Industry: Healthcare
  • Frequency: Each surgery
  • Estimated Time: 5-10 minutes
  • Role: Surgical Team
  • Total Items: 32
  • Compliance: WHO Surgical Safety, Joint Commission, AORN Guidelines

Sign In (Before Induction)

Before anesthesia.

  • Patient identity confirmed?
  • Site marked (if applicable)?
  • Consent signed?
  • Known allergies reviewed?
  • Airway risk assessed?

Time Out (Before Incision)

Pause before surgery.

  • Team members introduced?
  • Patient name, procedure, site confirmed?
  • Antibiotics given within 60 min?
  • Essential imaging displayed?

Sign Out (Before Leaving OR)

Before patient leaves.

  • Procedure name recorded?
  • Instrument/sponge counts correct?
  • Specimens labeled?
  • Equipment problems documented?
  • Key recovery concerns discussed?

Pre-Assessment Information

Initial assessment documentation and patient/facility identification

  • Assessor Name / Credentials
  • Assessment Date
  • Department / Unit
  • Assessment Type (Routine/Annual/Complaint)
  • Previous assessment findings reviewed?

Infection Prevention & Control

Verify infection control practices per CDC and Joint Commission standards

  • Hand hygiene compliance observed?
  • Appropriate PPE available and properly used?
  • Isolation precautions properly implemented?
  • Sharps containers available and not overfilled?
  • High-touch surfaces properly disinfected?

Patient Safety & Identification

Verify patient safety protocols and identification procedures

  • Two patient identifiers used before procedures?
  • Fall risk assessment completed?
  • Call light within patient reach?
  • Bed in lowest position with brakes locked?

Medication Safety & Management

Verify medication handling and administration practices

  • Medications stored securely and at proper temperature?
  • Controlled substances properly secured and counted?
  • No expired medications in stock?
  • High-alert medications properly labeled?

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Why Use This Surgical Safety Checklist?

This surgical safety checklist helps healthcare teams maintain compliance and operational excellence. Designed for surgical team professionals, this checklist covers 32 critical inspection points across 7 sections. Recommended frequency: each surgery.

Ensures compliance with WHO Surgical Safety, Joint Commission, AORN Guidelines. Regulatory-aligned for audit readiness and inspection documentation.

Frequently Asked Questions

What does the Surgical Safety Checklist cover?

This checklist covers 32 inspection items across 7 sections: Sign In (Before Induction), Time Out (Before Incision), Sign Out (Before Leaving OR), Pre-Assessment Information, Infection Prevention & Control, Patient Safety & Identification, Medication Safety & Management. It is designed for healthcare operations and compliance.

How often should this checklist be completed?

This checklist should be completed each surgery. Each completion takes approximately 5-10 minutes.

Who should use this Surgical Safety Checklist?

This checklist is designed for Surgical Team professionals in the healthcare industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.

Can I download this checklist as a PDF?

Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.

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