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Office Surgical Checklist Pilot Study

Office Surgical Checklist Pilot Study. I ntroduction Preoperative encounter; with practitioner and patient Patient Patient medically optimized for the procedure? Yes No, and plan for optimization made. Does patient have DVT risk factors? Yes, and prophylaxis plans arranged. No

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Office Surgical Checklist Pilot Study

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  1. Office Surgical Checklist Pilot Study

  2. Introduction • Preoperative encounter; with practitioner and patient • Patient • Patient medically optimized for the procedure? • Yes • No, and plan for optimization made. Does patient have DVT risk factors? • Yes, and prophylaxis plans arranged. • No • Procedure • Procedure complexity and sedation/analgesia reviewed? • Yes • NPO instructions given? • Yes • Escort and post-procedure plans reviewed? • Yes

  3. Setting • Before patient in procedure room; with practitioner and personnel • Emergency equipment check complete • (e.g. airway, AED, code cart, MH kit)? • Yes EMS availability confirmed? • Yes • Oxygen source and suction checked? • Yes • Anticipated duration < 6 hours? • Yes • No, but personnel, monitoring and equipment available

  4. Operation Before sedation/analgesia; with practitioner and personnel* Patient identity, procedure, and consent confirmed? oYes Is the site marked and side identified? oYes oN/A DVT prophylaxis provided? oYes oN/A Antibiotic prophylaxis administered within 60 minutes prior to procedure? oYes oN/A Essential imaging displayed? oYes oN/A Practitioner confirms verbally: oLocal anesthetic toxicity precautions oPatient monitoring (per institutional protocol). oAnticipated critical events addressed with team. oEach member of the team has been addressed by name and is ready to proceed.

  5. Before Discharge On arrival to recovery area; with practitioner & personnel Assessment for pain? oYes Assessment for nausea/vomiting? oYes Recovery personnel available? oYes Prior to discharge (with personnel and patient) Discharge criteria achieved? oYes Patient education and instructions provided? oYes Plan for post-discharge follow-up? oYes Escort confirmed? oYes

  6. Satisfaction Completed post-procedure; with practitioner and patient Unanticipated events documented? oYes Patient satisfaction assessed? oYes Provider satisfaction assessed? oYes

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