Standards Maintained Per Policy

Standards Maintained Per Policy

OR OBSERVATION CHECKLIST

Date of observation: ______Time: ______Observers: ______

OR/PATIENT STANDARDS / Compliant: YES / Compliant: NO / NA / DESCRIPTION/COMMENTS
OR Environment:
OR appears clean
OR facility in good repair
Sub-sterile area appears clean
Scrub sink area appears clean
Interim (between cases) cleaning performed
Ventilation requirements:
  • Positive pressure

  • Doors closed

Temperature 68 degrees F
  • If not, changed for case

by anesthesia?
Perioperative Patient Care:
Pre-op shower documented
Patient drug allergies noted
Pre-op antibiotic given by anesthesia personnel within 60 minutes prior to incision
Dress code followed:
  • Jewelry

  • Fanny packs

  • Long sleeves

  • Turtlenecks

  • Shirts tucked

Only those in appropriate attire enter the OR
Surgical Hand Scrub
  • Product used

  • Correct procedure for product

  • Nail cleaner used for first case

No artificial nails, natural nails correct length

/ Sterile Field:
Sterile items left open no > than 30 minutes prior to patient entering room
Scrubbed persons maintain sterility of sterile gown, gloves, supplies
Hands remain above waist
Sterile field constantly monitored
Items introduced into sterile field opened, dispensed, transferred by methods to maintain sterility/integrity
Items/devices dropped below level of the OR table are considered contaminated
All personnel moving in/around sterile field do so in manner to maintain sterility
Adjacent sterile fields not at disparate heights
Separation of sterile team from non-sterile team maintained
Staff do not turn back to sterile field
Traffic in and out of room kept to minimum
ADDITIONAL STANDARDS / DESCRIPTION/COMMENTS

Anesthesiology:

Drainage bags kept off the floor
Aseptic practice used for IV tubing, fluids, medications
Aseptic practice used for all invasive procedures: (epidurals, blocks, IV insertion)
Anesthesia cart appears clean
Cleans shared equipment (e.g, stethoscope) between cases
OSHA/Blood borne Pathogens
Appropriate eye protection used
Sharps containers not overfull
Shoe covers/boots if indicated
Surgeons/first assistants double gloved (recommended)
Circulators wear latex/nitrile gloves for handling contaminated items. Performs hand hygiene after glove removal
Sharps are passed in a basin or by using neutral zone rather than by hand
Sharps safety devices
General Infection Control:
Patients with communicable disease handled appropriately
Sterile team removes gloves and washes hands at end of case
Policies regarding flash sterilization are followed
Personnel appear free from communicable disease (no open skin lesions on hands/face)
Observers comply with “Observers Protocol” for Surgical Services
Clean, sterile, and soiled items are kept separate
Patient transported via clean corridor
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