According to the WHO surgical safety checklist, which of the following is completed in the 'sign out' phase?

NORCERT 8 Mains-2025

Medical & Surgical Nursing

Easy

Appeared in: NORCERT 8 Mains-2025

Explanation

The WHO Surgical Safety Checklist is a globally recognized tool to improve patient safety, structured into three phases: Sign In, Time Out, and Sign Out.
The 'Sign Out' phase is the final safety check conducted before the patient leaves the operating room.
A core component of the Sign Out phase is the verbal confirmation by the nurse that all instrument, sponge, and needle counts are correct, which is crucial for preventing Retained Surgical Items (RSIs).

Option A: Confirming the patient's identity is a foundational safety check, but it occurs at the very beginning of the process.
Option C: Confirming that the surgical site is marked is essential to prevent wrong-site surgery, but this check is performed earlier in the process.
Option D: The administration of prophylactic antibiotics is time-sensitive and needs to be confirmed before the procedure starts to ensure efficacy.

Visual 1: Infographic - A chart displaying the three columns of the WHO Surgical Safety Checklist (Sign In, Time Out, Sign Out) with the key questions and actions for each phase clearly listed.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Phases and activities of the WHO Surgical Safety Checklist as background academic context rather than a clinical decision trigger.
The checklist is a critical tool to improve team communication and consistency of care, reducing the number of preventable surgical errors, complications, and deaths.
The 'Sign Out' count is the final safeguard against Retained Surgical Items (RSIs), a serious but preventable 'never event' that can lead to severe patient harm and legal consequences.
What if? If the instrument or sponge count is incorrect during Sign Out, the surgical team must not close the wound. A systematic recount is initiated, and if the item is still missing, an intraoperative X-ray is typically performed before the patient leaves the operating room to locate it.

How to Approach the Question

This is a factual recall question about a standard nursing protocol.
First, identify the core concept: the WHO Surgical Safety Checklist and its phases.
Recall or visualize the three distinct phases: Sign In (before anesthesia), Time Out (before incision), and Sign Out (before patient leaves OR).
Mentally place each option into one of these three phases based on the timing and purpose of the check.
The question specifically asks for the 'Sign Out' phase. Evaluate the options to find the activity that belongs to this final phase.
Checking instrument counts is logically the last thing done before closing the patient, confirming it belongs in the Sign Out phase.

Concept Tested & Keywords

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