According to WHO Surgical checklist, starting of surgery in OT, which task should be done before skin incision?

Appeared in: NIMHANS Nursing Officer - 2019

Explanation

The 'Time Out' is a critical safety pause conducted by the entire surgical team immediately before the first skin incision.
Its primary purpose is to perform a final verification of the correct patient, correct procedure, and correct surgical site to prevent catastrophic errors.
During the Time Out, team members introduce themselves, confirm prophylactic antibiotics were given, and discuss anticipated critical events of the surgery.
This step ensures that all team members are on the same page and that all final safety checks are complete before the irreversible step of an incision is made.

Option B: 'Time In' is not a standard, recognized phase within the official WHO Surgical Safety Checklist.
Option C: 'Sign In' is the first phase of the checklist, but it is performed before the induction of anesthesia, not before the skin incision.
Option D: 'Sign Out' is the final phase of the checklist, conducted after the procedure 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.
Adherence to the WHO Surgical Safety Checklist is a global standard of care that has been proven to significantly reduce surgical complications, infections, and mortality.
The circulating nurse often has the primary responsibility for initiating each phase of the checklist, ensuring all team members actively participate, and documenting its completion.
Patient safety is paramount. The checklist empowers any member of the surgical team to speak up and halt the process if a safety concern is identified.

How to Approach the Question

First, identify the key phrase in the question: 'before skin incision'. This specifies a precise moment in the surgical timeline.
Next, recall the three distinct phases of the WHO Surgical Safety Checklist and their sequence.
The three phases are: 1. Sign In, 2. Time Out, and 3. Sign Out.
Mentally map each phase to its corresponding time: 'Sign In' occurs before anesthesia, 'Time Out' occurs before incision, and 'Sign Out' occurs before the patient leaves the OR.
Match the question's timing ('before skin incision') with the correct phase, which is 'Time Out'.
Eliminate the other options based on their incorrect timing and recognize that 'Time In' is not a standard part of the checklist.

Concept Tested & Keywords

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

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 71-73

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