A universal protocol for marking surgical sites and verifying correct patients and procedures will become mandatory in July 2004 at all hospitals, surgery centers and office-based surgery sites accredited by the Joint Commission on Accreditation of Healthcare Organizations. The protocol, finalized this week, is supported by more than 40 healthcare associations and medical societies. Prevention of wrong-site and wrong-patient surgery is one of the JCAHO's seven required patient-safety goals. But differences among the protocols facilities have established for preventing such mistakes led to an effort beginning last May to agree on one set of procedures that would start early in the pre-surgical process.
For example, markings on a patient could signify the surgical area, warn against operating on the identified area or communicate other meanings. The new protocol calls for marking only the operative site and using a marker that won't be washed away during skin preparation. It also calls for the person doing the procedure to mark the site, with the patient awake and aware if possible or with participation of a family member if the patient is not conscious. Verification of the correct person, procedure and site should occur at several junctures when applicable, including at the time of scheduling, admission and whenever responsibility for care is transferred to another caregiver. Read the guidelines. -- by John Morrissey