Taking Time for Patient Safety the Norm at Naval Hospital Bremerton

Photo By Douglas Stutz | Making and taking the time for National Time Out Day, always...in conjunction with National Time-Out Day, Naval Hospital Bremerton Main Operation Room staff follow the ‘Surgical Safety Checklist,’ adapted from the World Health Organization’s ‘Surgical Safety Checklist,’ and the Joint Commission’s ‘Universal Protocol’ for patient-safety. For example, prior to the patient in the room, the team will huddle to go over such protocols as confirming that all team members are available and/or present and confirm that all required instruments and supplies are available (Official Navy photo by Douglas H Stutz, NHB Public Affairs).  

BREMERTON , WA, UNITED STATES

06.14.2017

Story by Douglas Stutz    

Naval Hospital Bremerton/Navy Medicine Readiness and Training Command Bremerton

National Time-Out Day at Naval Hospital Bremerton (NHB) required no referee, no whistle, and no stoppage of play, just routine adherence to patient-safety protocols.
“Because every day here is National Time-Out Day for us,” said Lt. Cmdr. Jeff Dewey, Main Operating division officer.
National Time Out Day held on June 14 was a Joint Commission and Association of periOperative Registered Nurses undertaking to raise awareness of practices that prevent wrong-site, wrong-side, wrong procedure or wrong-person surgery.
“Our time-outs are always all about patient safety,” exclaimed Lt. Cmdr. Jill Skeet, Deputy Director, Nursing Services.
According to Dewey, everyone engaged in any surgery process is also involved in every time-out, from doctor to nurse to anesthesiologist to surgical technologist.
“Either the surgeon or nurse will initiate the time-out process, where we will thoroughly review the patient’s chart, starting with verifying their identity. We’ll talk to the patient about the procedure, verify their consent and include going over items as the exact anatomical location,” explained Dewey.
NHB uses a ‘Surgical Safety Checklist,’ adapted from the World Health Organization’s ‘Surgical Safety Checklist,’ and the Joint Commission’s ‘Universal Protocol.’ In the OR, prior to the patient in the room, the team will huddle to go over such protocols as confirming that all team members are available and/or present and confirm that all required instruments and supplies are available.
The anesthesia provider will go over the plan of care, antibiotics to be used, and any possible concerns. The anesthesia provider will also conduct an anesthesia equipment safety check; confirm the pulse oximetry and other pertinent monitors are placed on the patient - and functioning properly - and that the time-out procedure is completed prior to the regional anesthetic administration.
Prior to the start of the procedure, there will the ‘Universal Protocol’ time out which has everyone stop what they are doing and focus on the timeout. The surgeon, anesthesia provider, OR nurse and surgical technologist will verbally confirm on a number of requirements, such as ensuring the patient understands the planned procedure, and that relevant images and results are labeled and available.
The surgeon will discuss the plan of action and go over any potential issues and special requests. The surgical technologist will go over the sterilized gear and any anticipated needs.
The nurse will wrap up the session with a follow-up synopsis of everyone’s input and comment on any concern. The entire open-ended discussion lasts approximately several minutes.
“Our time-out before every patient definitely makes my job easier. We make sure everyone knows the plan of action during the surgery process,” commented Cmdr. David Hessert, Ophthalmologist.
There is also another condensed time-out conducted – ‘60 seconds for safety’ – initiated by the circulating nurse after every surgical procedure is completed that gives everyone on the team a chance to share, and go over if there were issues about equipment, instrumentation, and even any concern on the patient’s recovery process.
“Every time-out is imperative in everything we do,” added Skeet, stressing that the TeamSTEPPS concept – a multi-team approach for patient-care – is considered a routine part of the Main OR daily procedure.
Even before an individual case time-out, the Main Operating Room staff will hold a team huddle to go over the day’s surgical case load, including specific patient status – plus health issues if necessary – go over the procedures planned, contingencies in place, and instrumentation needed for the scheduled surgeries that day.
Although TeamSTEPPS principles were introduced at NHB in June, 2009, there was already a multi-team approach in place for patient care in the Main OR before, during if needed, and after any surgical procedure. Then, as now, the time-out provided the ability to exchange necessary surgical strategies and tools with all involved, including the patient, with the goal of continuing to focus on patient safety and patient-care, as well as improve communication, and develop successful leadership by all team members.

The National Time-Out Day is another tool that all staff members of NHB’s Main Operating Room can implement to ensure the commitment to patient-safety remains the norm.

• Date Taken: 06.14.2017
• Date Posted: 06.15.2017 13:26
• Story ID: 238055
• Location: BREMERTON , WA, US