Correct Site Surgery © Association for Perioperative Practice 2006

Second check to be made by ward/day care staff prior to patient leaving ward/day care area:

inspect mark against patient’s supporting documentation – patient’s notes, consent form, patient’s I.D. band

ensure availability of relevant imaging studies in operating theatre/suite

Third check to be made by operating surgeon or competent nominateddeputy in anaesthetic room prior to anaesthesia:

inspect mark and check against supporting documentation – patient’s notes, consent form, patient’s I.D. band

re-check imaging studies

check availability of correct implant (where appropriate)

Final check to be made by the entire team. Surgical, anaesthetic and theatre team pausebefore commencing surgery for everyone present to confirm:

presence of correct patient

marking of the correct site

procedure to be performed

First check to be made by surgeon or competent nominated deputy to be present at operation:

check patient’s identity band or ask patient to identify themselves – name and date of birth. Involve patient/family member/significant other

check reliable documents/image for intended surgical site – patient’s notes and consent form

mark with an indelible pen using an arrow at or near the intended incision. For digits the arrow should extend to the correct specific digit(s)

1

2

3

4Circumstances where marking maynot be appropriate:

emergency surgery should not be delayed

surgery on teeth or mucous membranes

bilateral procedures such as tonsillectomy and squint surgery

situations where laterality of surgery will be confirmed during the procedure

If a patient refuses preoperative skinmarking local policy should be followed but include:

document patient’s request in the nursing and medical notes

complete correct site surgery checklist but clearly state patient refuses marking. This will ensure staff are aware at each stage of the process

managing the risk

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Correct S

ite Surgery

managing the risk

12

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