| # |
Step |
Instructions |
Good Skills (Learning Objectives) |
Common Errors |
Guidance |
|---|
| 1 |
Environmental readiness check and gather supplies |
Articulates that OR environmental cleaning checklist / terminal cleaning checklist are completed |
| 2 |
Verify:
- Planned procedure
- Surgeon requirements/preferences
- Special equipment needs
|
Articulates planned procedures and setup/special equipment required confirmed with surgeon |
| 3 |
Gather supplies |
Articulate that all needed equipment is available and ready |
| 4 |
Check and position OR furniture |
Position OR bed/table, Mayo/side tables, anesthesia workstation and stools; ensure clear transfer space and walkways. |
Correct ergonomic layout; unobstructed walkways; table aligned with lights; patient transfer space ready |
Poor positioning causing crowding or obstruction; table not aligned to lights |
Do a quick walk-around: transfer path, anesthesia access at head, and clear entry and exit routes. |
| 5 |
Check lighting |
Power on overhead/portable lights; position over expected field; confirm focus, intensity and movement range. |
Lights positioned over surgical field; bulbs working, light arms stable; adjustable focus, intensity and movement range confirmed |
Lights not tested; burned-out bulbs discovered during surgery; lights positioned incorrectly away from the operative field; focus or intensity not adjusted appropriately; movement range and stability of light arms not checked |
Confirm sterile light handles/covers are available if used; set initial position for average patient height and expected surgical field. |
| 6 |
Check suction system |
Assemble canister/tubing; connect to wall/portable suction; test suction; keep spare canister/tubing. |
Test suction function; correct tubing connections; spare canister ready |
Weak suction pressure; leaks or blockages in tubing; no spare canister |
If weak, check canister seal, tubing kinks, regulator, and power source (if portable). |
| 7 |
Check anesthesia machine |
Confirm anesthesia team has completed machine check; verify oxygen source present; ensure readiness for patient arrival. |
Verify with anesthesia lead that machine tested per protocol; oxygen supply adequate; circuits leak-checked; all alarms and safety systems functional |
Oxygen empty; leaks or disconnections in circuit; machine not tested before case |
If the machine is not cleared, pause room readiness sign-off and escalate to anesthesia lead. |
| 8 |
Set up waste disposal system |
Place sharps containers and labeled waste bins in standard locations; ensure liners are present and accessible. |
Clearly labeled, color-coded bins in correct locations |
Bins missing, not within reach of procedural area, or mislabeled; sharps container absent |
If not properly organised, stop and correct the setup by repositioning or replacing waste containers before proceeding. |
| 9 |
Verify available surgical instrument sets |
Check correct set(s) for planned case; confirm seals intact; verify sterility indicators/expiry as visible; stage for opening. |
Confirm availability and correct type; check seals intact |
Missing sets; damaged packaging; incorrect sets pulled |
Escalate early — avoid opening incorrect sets and wasting sterile supplies. |
| 10 |
Arrange sterile supplies (without opening) |
Check correct set(s) for planned case; confirm seals intact; verify sterility indicators/expiry as visible; stage for opening. |
Sterile packs placed on clean, dry surfaces; labels visible; expiry dates checked |
Expired packs; damaged packaging; placed on contaminated surfaces |
Leave a clear landing zone for opening; avoid stacking that crushes packaging or hides indicators. |
| 11 |
Check patient positioning equipment |
Confirm needed positioning aids (straps, padding, armboards, stirrups, head ring) are present, intact, and clean. |
Equipment present, clean, functioning and within reach |
Equipment missing or not easily accessible; straps frayed; padding torn |
Match to likely case needs before the patient arrives; replace/flag damaged items. |
| 12 |
Set up auxiliary equipment such as diathermy, warming devices |
Route cords to reduce trip/pull risk; keep plugs accessible; avoid crossing walkways. |
Cables inspected; grounding pads ready; devices tested |
Faulty cables; ESU not tested; warming device missing |
Route cords to reduce trip/pull risk; keep plugs accessible; avoid crossing walkways. |
| 13 |
Verify emergency equipment, supplies and medications |
Confirm crash cart access and key items (functional airway equipment, supplies, medications, oxygen) reachable; verify charge/power. |
Fully stocked; airway equipment (defibrillator, bag valve mask, suction) functional; equipment, supplies and medications accessible |
Missing medications/supplies/equipment; defibrillator not charged |
Quick reach test:
- Can the team access the emergency kit without moving clutter?
- Can the team identify the backup location of emergency items before starting?
|
| 14 |
Patient data board, time-out list and count board |
Prepare checklist/time-out materials; set up a count board; ensure patient placeholders are ready (update at time-out). |
OR safety checklist and time-out set up for patient to be operated on with current, up-to-date information |
Missing OR safety checklist and/or count board |
Limit premature PHI (patient health information); update immediately before time-out; keep board visible to the team. |
| 15 |
Final room readiness check |
Run a final sweep: clear pathways, remove hazards, confirm stations ready, retrieve or escalate missing items. |
All stations ready; pathways clear; alarms and safety systems activated; safety hazards removed |
Missing items; clutter; alarms and safety systems not functional; tripping hazards present |
Use a consistent sweep order (door → anesthesia → scrub/circulator → exits) to avoid omissions. |
| 16 |
Ensure backup energy supply |
Verbalizes that backup energy supply is checked and functional |