According to the WHO Surgical Safety Checklist, which task should be done before skin incision in the operati… - AIIMS Delhi NO - 2018

AIIMS Delhi NO - 2018

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO - 2018

Explanation

The WHO Surgical Safety Checklist mandates a 'Time Out' as a crucial safety pause immediately before the skin incision.
During the Time Out, the entire surgical team (surgeon, anesthetist, nurse) stops all activity to confirm critical details: correct patient, correct procedure, and correct surgical site.
This step is designed as a final safety net to prevent wrong-site, wrong-procedure, and wrong-patient errors, which are considered 'never events' in healthcare.
Other checks during this phase include confirming antibiotic prophylaxis was given and discussing anticipated critical events for the surgery.

Option B: 'Time In' is not a recognized phase or term used in the official WHO Surgical Safety Checklist.
Option C: 'Sign In' is the first phase of the checklist, but it occurs before the induction of anesthesia, which is earlier than the 'before skin incision' timeframe specified in the question.
Option D: 'Sign Out' is the final phase of the checklist. It is performed after the surgery is completed and before the patient leaves the operating room.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Phases of the WHO Surgical Safety Checklist as background academic context rather than a clinical decision trigger.
Nurses, particularly the circulating nurse, play a pivotal role in initiating and leading the checklist, ensuring every step is completed and documented. This is a core nursing responsibility for patient advocacy and safety.
Active participation by all team members in the Time Out is crucial. It empowers any team member, including the nurse, to voice concerns and halt the procedure if there is any discrepancy or safety concern, preventing potential harm.
In the Indian healthcare context, consistent implementation of the WHO checklist is a key quality indicator for hospitals, especially those with NABH (National Accreditation Board for Hospitals & Healthcare Providers) accreditation.

How to Approach the Question

First, identify the key elements of the question: 'WHO Surgical Safety Checklist' and the specific timing, 'before skin incision'.
This is a factual recall question based on a standard international protocol. Your goal is to access your knowledge of the checklist's phases.
Mentally visualize or recall the three distinct phases of the checklist: Sign In, Time Out, and Sign Out.
Associate each phase with its specific timing in the perioperative workflow: Sign In (before anesthesia), Time Out (before incision), and Sign Out (before leaving OR).
Match the timing in the question ('before skin incision') with the correct phase ('Time Out').
Eliminate the other options based on their incorrect timing and eliminate 'Time In' as it is not a standard term.

Concept Tested & Keywords

Concept Tested: Phases of the WHO Surgical Safety Checklist
Stem keywords: WHO Surgical Safety Checklist, before skin incision, operating theater
Lead-in keywords: which task
Negative lead-in flag: false

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