Correct Patient, Procedure, Site - Hip Replacement
At Highland Hospital, the following steps are taken to ensure correct-patient, correct-procedure, and correct-site for hip surgery:
The intended site is specified on the procedure schedule.
Appropriate documents are reviewed to ensure consistency of site and are compared with the staff's understanding of the intended patient, procedure, and site.
The procedure site is marked with an "X" by the patient.
The provider initials the site after confirmation by the patient and provider.
A pause for confirmation is conducted in the operating room prior to surgery.
Wrong-patient, wrong-procedure, or wrong-site surgeries are uncommon, but they can be avoided altogether by following careful procedures prior to surgery. The following procedures cover broad areas of concern in preventing surgical mishaps; however, there are additional safeguards used by surgical teams that are not listed here.
The first procedure involves review of relevant medical records prior to surgery. These records may contain information that will prevent the need for additional tests, saving time and money. They may also provide vital facts about your health history that your surgical team needs to know.
Secondly, according to the Joint Commission's Universal Protocol for Prevention of Wrong Site, Wrong Procedure, Wrong Person Surgery, it is recommended that the operating surgeon mark the operative site using a signature or other approved mark.
Extra care should be taken with moist areas that can smear onto another site such as the inside of the thigh, according to a report in Anesthesia and Analgesia (January 2005; 100 (1): 300). Smearing can occur where marked skin touches unmarked skin and the unintended marks may cause confusion about the correct site for surgery.
Lastly, just prior to surgery a final review is performed to ensure that the right patient is having the right procedure on the right body part, with all necessary patient information available. The armband may be checked several times during this process to verify that the team has the correct patient.
An opportunity for speaking up is provided during this final review; it is a built-in pause (time-out) to provide an opportunity for anyone on the surgical team to speak up about anything related to the procedure or patient that is questionable.