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Clinical

Operation Theatre

The operating list per theatre, the team, the pre-operative orders; the WHO surgical safety checklist as nineteen named items read aloud in three phases; two independent counts before closure; the operative note signed and locked; consumables and implants charged; theatre utilisation measured.

For:Theatre nursesSurgeonsAnaesthetistsTheatre manager

Where:Surgery › Surgeries · Theatres · Theatre Utilisation · Configuration › Safety Checklist

The operating list per theatre and day.
The operating list per theatre and day.
The surgery: team, checklist, counts, the record and the charges.
The surgery: team, checklist, counts, the record and the charges.

Before you start

Theatres
Surgery › Configuration › Theatres: rooms and their sessions.
Checklist items
Surgery › Configuration › Safety Checklist: the nineteen WHO items ship; edit the wording or add local items. Items marked “read aloud” exist to be said, not ticked.

How to

Schedule an operation

  1. Surgery › Surgeries › New: patient, procedure (from the service catalogue), surgeon, anaesthetist, theatre, date and planned duration, urgency.
  2. Pre-operative orders (bloods, imaging, consent) are raised from the surgery; the consent shows on the surgery once signed.
  3. Confirm; it appears on the theatre’s list.

Run the safety checklist

  1. On the day, Build the checklist on the surgery (once).
  2. Sign In — before induction: the nurse reads each item aloud; the team confirms; tick Checked (or N/A with a note). Click Sign In when the phase is complete; an incomplete phase is refused and names what is missing.
  3. Time Out — before skin incision: introductions by name and role; patient, site and procedure confirmed aloud by surgeon, anaesthetist and nurse; critical steps, blood loss, antibiotics, imaging. Click Time Out.
  4. Sign Out — before the patient leaves: the procedure name confirmed aloud, the counts complete, specimens labelled and read back, equipment problems, recovery concerns. Click Sign Out.

Count sponges, needles and instruments

  1. Counts tab: the opening count by two different people (the same person twice is refused).
  2. Before closure: the closing count by two people; it is compared with the opening count.
  3. A mismatch keeps the patient in the room: recount, or a surgery manager releases it with a reason (X-ray clear, item accounted for). The reason prints on the operative report.

Write and sign the operative note

  1. Procedure note, findings, post-operative diagnosis, complications, wound class (I clean to IV dirty).
  2. Sign the operative note: it is locked. Only a surgery manager can reopen it, and the previous text is kept in the chatter.

Charge consumables and implants

  1. Consumables tab: items issued from the theatre store are charged to the patient; implants with lot and serial.
  2. Theatre time and the surgeon’s and anaesthetist’s fees are captured for the bill and the doctor statement.

Cancel an operation and measure utilisation

  1. Cancel with the reason (patient unfit, no bed, surgeon unavailable, theatre or equipment, previous case overran, anaesthetic reason).
  2. Surgery › Theatre Utilisation: scheduled against actual minutes per theatre and day, turnover between cases, cancellations by reason.

See also: Admissions & Bed Board Certificates & Consents Bills, Charges & Cashier Ambulance, Diet, Housekeeping, CSSD & Mortuary

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