Which of the following is verified during the 'Sign In' phase of the WHO Surgical Safety Checklist, before induction of anaesthesia?

Appeared in: BTSC Staff Nurse 30July-2025

Explanation

The 'Sign In' phase is the first part of the WHO Surgical Safety Checklist, conducted before anaesthesia is administered.
Its primary purpose is to confirm the correct patient, the correct surgical site, and the correct procedure to prevent wrong-site, wrong-procedure, or wrong-patient errors.
This phase also includes a crucial anaesthesia safety check, which involves verifying equipment, medications, and assessing patient-specific risks like allergies or difficult airways.
Confirmation of patient identity, surgical site, and the anaesthesia safety check are all core components of the 'Sign In' process.

Option A: Surgical instrument, sponge, and needle counts, along with the correct labeling of any surgical specimens, are performed during the 'Sign Out' phase.
Option C: Postoperative instructions and discharge planning are part of the postoperative care phase, which begins after the patient has left the operating room and is in the recovery area (PACU).
Option D: Confirming the completion of the procedure and conducting a team debriefing about key concerns for recovery are key activities of the 'Sign Out' phase.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Phases and components 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 significantly reduces the risk of preventable surgical errors, known as 'never events' (e.g., wrong-site surgery).
As a nurse in the perioperative setting, you have a critical role in initiating and participating in all three phases of the checklist, acting as a patient advocate to ensure every step is completed correctly.
What if? If the patient is a child or is unable to confirm their identity due to confusion or language barriers, the nurse must use at least two patient identifiers (e.g., name and medical record number) and confirm with the patient's legal guardian or family member before proceeding.

How to Approach the Question

First, identify the core subject of the question, which is the 'WHO Surgical Safety Checklist'.
Next, pinpoint the specific phase mentioned: the 'Sign In' phase.
Recall or deduce the timing of this phase. The term 'Sign In' implies the beginning of a process, which in surgery means before anaesthesia is given and the procedure starts.
Evaluate each option based on this timing. Ask yourself, 'Does this action logically happen at the very beginning of the surgical encounter in the OR?'
Eliminate options that clearly happen at the end (e.g., counts, debriefing) or after the surgery (e.g., discharge planning).
Select the option that lists the fundamental safety verifications: right patient, right site, and readiness for anaesthesia.

Concept Tested & Keywords

Concept Tested: Phases and components of the WHO Surgical Safety Checklist.
Stem keywords: WHO Surgical Safety Checklist, Sign In phase, before induction of anaesthesia
Lead-in keywords: Which of the following

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

Practise the full BTSC Staff Nurse 30July-2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.