What protocols should have been followed to prevent the confusion in such a situation?
You are waiting for a RN Rosie has been working as an anaesthetic nurse for several months and she is in the anaesthetic room with Mrs A, who is to undergo a total knee replacement. Mrs A has had a premedication, which has made her drowsy, but she is clearly still very anxious and holding firmly onto Rosie's hand. Rosie notices that Mrs A's healthcare record and her consent form both state that the procedure that she is about to undergo is a right total knee replacement. The operating list in the operating suite has Mrs A listed for a left total knee replacement.
Rosie asks Mrs A to clarify which knee she is having replaced and Mrs A points to her right knee, but tells Rosie that ‘both knees are bad'. Rosie checks Mrs A's legs to see whether the surgeon has marked the operative site for today's procedure and notes that this has not occurred.
What will be an ideal response?
A patient/procedure checking process should have taken place in the ward or, in the case of patients admitted on the day of surgery (DOSA), in the pre-admission area and on admission to the operating suite. In the case of the latter, a preoperative checklist that addresses patient/procedure checking (in addition to a range of other important aspects of care) should have been used by two nurses as part of the handover process. If this has not occurred, further action is required.
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