National Time Out Day on June 12 is more than just taking a short break or brief suspension.
It’s about using a temporary delay to become a champion and protector of others.
Naval Hospital Bremerton, in conjunction with the Association of periOperative Registered Nurses (AORN), is doing just that by reminding staff members to continue being superheroes for patient safety on National Time Out Day.
“If it seems simple, it’s because it is. It’s also effective. A time out is a powerful tool that supports a culture of safety and empowers anyone on the team to speak up for safety,” explained Cmdr. Kevin Burns, NHB Quality Management Department Head.
Even the 2019 National Time-Out Day theme of ‘Be a Time Out SUPERHERO’ features an acronym promoting patient safety. The S stands for ‘Support a safety culture,’ U is for ‘Use the Joint Commission Universal Protocol and AORN Surgical Checklist,’ P is for ‘Proactively reduce risk in the operating room,’ E is for ‘Effect change in your organization,’ R is for ‘Reduce harm in patients,’ H is for ‘Have frank discussions about hazardous situation,’ E is for ‘Empower others to speak up when a patient is at-risk,’ R is for ‘Respect others on the surgical team,’ and O is for ‘Openly seek opportunities for improving patient safety.’
“For a surgical patient and their family members and friends, a wrong-patient, wrong-site, or wrong-procedure surgery can be life-altering. A perioperative nurse’s role is to be the advocate for the patient. We are committed to reducing surgical errors and improving patient outcomes by taking a meaningful time out before each surgery for every patient, every time,” said Lt. Cmdr. Michelle Lind, NHB Directorate of Surgical Services, and department head for Main Operating Room, Sterile Processing department, Post Anesthesia Care Unit, and Endoscopy Clinic.
According to Lind, The Joint Commission requires surgical teams to take a ‘time out’ before operative and other invasive procedures so that surgical team members can confirm the correct patient is in the room and the team is prepared for the right procedure.
Despite this requirement, the Joint Commission estimates wrong-site surgeries occur 40 to 60 times each week nationwide. Lind attests that of the tens of millions of surgeries performed in the United States every year, it’s a rare occurrence. But because it’s preventable, it should never happen.
“That’s why, on National Time Out Day, hospitals and ambulatory surgery centers around the country are reminded to evaluate the quality of their operating rooms’ time out process. Time Out Day was established 15 years ago by AORN to support the protocol and build greater awareness for this crucial safety measure among surgical team members. As a proud member of AORN commitment to safe surgery, NHB Main Operating Room Perioperative Nursing Team wants to remind our colleagues and fellow shipmates to reaffirm our pledge to provide each surgical patient a focused time out, with the full and undivided attention of the entire surgical team. As a team, we can prevent errors,” Lind said, noting that NHB has adopted the Joint Commission’s Universal Protocol by using a checklist for each and every patient and procedure.
Prior to a patient entering NHB’s Main Operating Room, all team members - surgeon, anesthesia provider, perioperative nurse and surgical technicians - meet in the room to perform a TeamSTEPPS huddle to confirm availability of instruments and supplies, review patient’s medical history, and address all team members concerns.
“After the patient has entered the operating room and prior to the start of the procedure, all personnel in the room will stop what they are doing to focus on the time out,” said Lind, going over such concerns that consent is verified, patient identity is confirmed by asking for name and date of birth; the correct surgery site and side markings are visible; and the planned procedure is confirmed. Additional details are also validated such as known allergies discussed and safety precautions addressed.
“The anesthesia provider will (also) confirm type of anesthesia and antibiotic prophylaxis. The surgical technician will confirm all medications, fluids and irrigations are properly labeled and confirm instrument sterility. Finally, the surgeon will recap the procedure and site and address any key concerns,” added Lind.
The National Time Out Day might come once a year, but the patient-safety principles are practiced every DAY - and every time - by superheroes at NHB.