Preprocedure verification, site marking, and the time-out procedures should be as consistent as possible throughout the organization. The 3 components of the Universal Protocol are not necessarily presented in chronological order (although the preprocedure verification and site marking precede the final verification in the time-out). The frequency and scope of the preprocedure verification will depend on the type and complexity of the procedure. Organizations should identify the timing and location of the preprocedure verification and site marking based on what works best for their own unique circumstances. In some organizations, it may be necessary to be more prescriptive on certain elements of the Universal Protocol or to create processes that are not specifically addressed within these requirements. ![]() An organization should consider its culture when designing processes to meet the Universal Protocol. The Universal Protocol is implemented most successfully in organizations with a culture that promotes teamwork and where all individuals feel empowered to protect patient safety. Consistent implementation of a standardized protocol is most effective in achieving safety.To the extent possible, the patient and, as needed, the family are involved in the process.Active involvement and use of effective methods to improve communication among all members of the procedure team are important for success.A robust approach using multiple, complementary strategies is necessary to achieve the goal of always conducting the correct procedure on the correct person, at the correct site.Wrong-person, wrong-site, and wrong-procedure surgery can and must be prevented.The Universal Protocol is based on the following principles: Organizations can enhance safety by correctly identifying the patient, the appropriate procedure, and the correct site of the procedure. Evidence indicates that procedures that place the patient at the most risk include those that involve general anesthesia or deep sedation, although other procedures may also affect patient safety. “The Universal Protocol applies to all surgical and nonsurgical invasive procedures. Note that the hospital determines the amount and type of documentation required. For example, when reviewing the Elements of Performance for UP.01.03.01 as documented by The Joint Commission, the following checklist could be used to ensure clinical and operational accuracy in this standard. ![]() To comply with this standard, one must customize the hospital’s policy and procedure, create a checklist for team members to follow, and institute and verify the checklist according to facility requirements. ![]() Defined under UP.01.03.01, a time-out is performed before a procedure to verify the procedure, patient, and site. One example of using a checklist to help maintain compliance in the hospital involves a time-out, which is one of The Joint Commission’s 2016 National Patient Safety Goals. In wound care, clinical and operational rules help maintain compliance with standards, and checklists can provide an audit tool to ensure that requirements have been followed.
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