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Purpose

To ensure the correct surgical site is verified and marked for all surgical procedures to prevent wrong- site surgeries.

Policy Number

CLI.6611.PL.007

Background

  • Surgical Site Verification and Marking is a requirement of ORNAC and Accreditation Canada.
  • Existing Central Health Authority policies are outdated and need archiving.

Key Message

  • All surgical interventions require verification of the surgical site.
  • Mandatory steps for surgical site marking are outlined for procedures involving laterality or multiple structures (e.g., fingers, toes, limbs, eyes).
  • Complements Safe Surgery Checklist and Admission Criteria – Same Day Surgery policies.

Recommendation(s)/Action Required

  • OR staff and surgeons review new policy.
  • Ensure updated copies of required forms are available for use for each surgical case.

Timeline:

As soon as possible after publishing on StaffNET.

If you have any questions, please contact:

  • Site Director or Manager

Submitted by: L Cassan, Regional Lead – Acute Care & Chief Nursing Officer

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