Safety Checklist

WHO Safe Surgery Checklist

Before an operating list commences the WHO Safe Surgery Checklist. Is performed by all the staff allocated to that operating theatre and that patient.

“The checklist identifies three phases of an operation, each corresponding to a specific period in the normal flow of work: Before the induction of anaesthesia (“sign in”), before the incision of the skin (“time out”) and before the patient leaves the operating room (“sign out”). In each phase, a checklist coordinator must confirm that the surgery team has completed the listed tasks before it proceeds with the operation.” 1

Another member of staff should countercheck all drugs drawn up for anaesthetising patients. This is not mandatory except in the case of scheduled drugs (Narcotics and intravenous sedatives). A register of drug usage, patient name, the name of person who gave it and the person who checked it is kept. This information includes the amount given and the amount discarded.2

Once the patient is ready to proceed they are attached to clinical monitoring equipment. The minimum requirements necessary to comply with best practice are defined by the AAGBI.3 This extends into the recovery ward and, depending on whether he is to return to a High dependency ward or a general ward or whether he will be discharged home directly different guidelines will have to be followed.

During the course of the anaesthetic there are minimum standards expected of the anaesthetist.4


  • 1. World Health Organization
  • 2. A guide to good practice in the management of controlled drugs in primary care (England) 2009
  • 3. Recommendations For Standards Of Monitoring During Anaesthesia And Recovery 4th Edition. AAGBI London 2007
  • 4. The Anaesthesia Team Revised Edition 2005 Association of Anaesthetists of Great Britain and Ireland, 21 Portland Place, London W1B 1PY

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