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WHO surgical safety checklist template

WHO surgical safety checklist template

Enhance surgical safety and compliance with our comprehensive and customizable WHO surgical safety checklist template. Designed to help you conduct powerful quality audits and safety inspections, this template ensures adherence to best practices. Download your free PDF now from Lumiform.

Use this template
or download pdf
WHO surgical safety checklist template

Enhance surgical safety and compliance with our comprehensive and customizable WHO surgical safety checklist template. Designed to help you conduct powerful quality audits and safety inspections, this template ensures adherence to best practices. Download your free PDF now from Lumiform.

Use this template
or download pdf

About the WHO surgical safety checklist template

Ensuring compliance with WHO surgical safety standards is crucial for maintaining a safe and efficient surgical environment. Our WHO surgical safety checklist template is designed to help you conduct thorough pre-operative, intra-operative, and post-operative checks, identify potential risks, and ensure patient safety.

Using this template, you create a safer surgical environment and promote a culture of safety within your healthcare facility. Make your surgical procedures safer and more efficient with our easy-to-use checklist.

Transform your surgical safety protocols

The primary purpose of our WHO surgical safety checklist template is to provide a structured and systematic approach to surgical procedures that aligns with WHO safety standards. This template helps you identify and address potential risks before, during, and after surgery, ensuring patient safety and reducing the likelihood of complications.

Using this checklist, you streamline your surgical procedures, promote a culture of safety, and reduce the risk of errors in the operating room. It helps ensure compliance with WHO safety standards, which can prevent medical errors and enhance your healthcare facility’s reputation for patient safety. Ultimately supporting a proactive safety culture, leading to improved patient outcomes and increased trust in your healthcare services.

Key elements of the WHO surgical safety checklist template

Our WHO surgical safety checklist template includes several key elements to ensure comprehensive surgical safety checks. It covers critical areas such as:

  • Before induction of anesthesia (Sign In): Conduct checks to confirm the patient’s identity, surgical site, procedure, and consent. Ensure the site is marked, the anesthesia safety check is completed, and the pulse oximeter is on the patient and functioning. Verify if the patient has any known allergies, a difficult airway/aspiration risk, or a risk of significant blood loss.
  • Before skin incision (Time Out): Confirm that all team members have introduced themselves by name and role. The surgeon, anesthesia professional, and nurse should verbally confirm the patient, site, and procedure. Review anticipated critical events, including unexpected steps, operative duration, and anticipated blood loss. The anesthesia team should review any patient-specific concerns, and the nursing team should confirm sterility, equipment issues, and any concerns. Ensure that antibiotic prophylaxis has been given within the last 60 minutes and that essential imaging is displayed.
  • Before the patient leaves the operating room (Sign Out): The nurse should verbally confirm with the team the name of the procedure recorded, that instrument, sponge, and needle counts are correct (or not applicable), how the specimen is labeled (including patient name), and whether there are any equipment problems to be addressed. The surgeon, anesthesia professional, and nurse should review key concerns for recovery and management of the patient.

Each section is meticulously designed to guide you through specific surgical safety checks, helping you identify and mitigate risks effectively. The template also includes space for notes and observations, allowing you to document any issues and track corrective actions.

Get started with Lumiform’s WHO surgical safety checklist template

Ready to enhance safety in your surgical procedures? Download Lumiform’s free WHO surgical safety checklist template today and start conducting thorough and effective surgical safety checks.

Our user-friendly template will help you ensure compliance, protect your patients, and maintain a high standard of care. Don’t wait—take the first step towards a safer surgical environment now! Download your free checklist and transform your surgical safety standards with Lumiform.

Click here to get started today!

Related categories

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Preview of the template
Before induction of anaesthesia
Sign In
Patient has confirmed:
Identity
Site
Procedure
Consent
Site marked
Anesthesia safety check completed
Pulse oximeter on patient and functioning
Does Patient have a:
Known allergy?
Difficult airway/aspiration risk?
Risk of >500 ml blood loss (7ml/kg in children)
Before skin incision
Time out
Confirm all team members have introduced themselves by name and role
Surgeon, anesthesia professional and nurse verbally confirm Patient Site Procedure
ANTICIPATED CRITICAL EVENTS
SURGEON REVIEWS: What are the critical or unexpected steps, operative duration, anticipated blood loss?
ANAESTHESIA TEAM REVIEWS: Are there any patient-specific concerns?
NURSING TEAM REVIEWS: Has sterility (including indicator results) been confirmed? Are there equipment issues or any concerns?
Has antibiotic prophylaxis been given within the last 60 minutes?
Is essential imaging displayed?
Before patient leaves operating room
Sign Out
Nurse verbally confirms with the team:
The name of the procedure recorded
That instrument, sponge, and needle counts are correct (or not applicable)
How the specimen is labeled (including patient name)
Whether there are any equipment problems to be addressed
The surgeon, anesthesia professional, and nurse review the key concerns for recovery and management of this patient
Confirmation
Signature (on behalf of the entire team)
This template was downloaded 16 times

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Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

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Frequently asked questions

What are the common issues I might face with the WHO surgical safety checklist?

You might encounter challenges such as incomplete documentation, lack of adherence to protocols, and communication gaps. Transitioning to regular checklist reviews can help ensure compliance, improve surgical outcomes, and enhance patient safety by addressing these issues proactively.

How can my organization ensure effective implementation of the WHO surgical safety checklist?

Your organization can ensure effective implementation by training your team thoroughly, conducting regular audits, and fostering a culture of safety. Transitioning to digital checklists can streamline processes, improve accuracy, and facilitate better communication among your surgical team.

Why is it important for my team to use the WHO surgical safety checklist consistently?

Consistent use of the checklist enhances patient safety, reduces surgical errors, and improves team collaboration. Transitioning to a routine checklist practice ensures your team maintains high standards of care, ultimately benefiting your organization’s reputation and patient trust.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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