Preoperative Checklist

Ensured that all required equipment and implants are available

Verified that the antibiotic protocol was implemented and is compliant with the facility
preoperative antibiotic policy

Implemented beta blocker management plan as appropriate

Verified availability of ordered blood products

Assessed for deep vein thrombosis (DVT) risk and implemented prevention strategies as
appropriate

Ensured that a completed general agreement is available

Assessed glycemic status and implemented glycemic management strategies as indicated

Obtained the patient’s informed consent for anesthesia or moderate sedation (or N/A)

Obtained the patient’s informed consent for the surgical procedure

Ensured that the 24-hour nursing assessment has been completed on the day of surgery

Verified that the patient’s medical history and physical examination were completed within 30
days of the procedure

Identified the correct patient using two patient identifiers

Checked the availability of pertinent diagnostic and radiological test results

Completed the preprocedure anesthesia assessment (or N/A)

Ensured that the surgeon and patient cooperatively identified and marked the correct surgical
site and side (or N/A)