Template Information
To observe intraoperative procedures
Category: general
Template Questions
- OR Personnel: Surgeon: Assistant: Anesthesia:
- Time out completed according to policy?
- Surgical Scrub
- Surgical Attire (every person)
- Surgical Prep of the Patient
- Prep agent:
- Sterile Technique
- Traffic
- Environmental Cleaning
- Action plan due to Infection Control by: Action plan as decided by department Director and/or designee:
- Infection Control Practitioner
- OR Director or Designee