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SaferPatients.com > Forums > Hardwired Safety Tools Workshops And Implementation > CABG Time Out
 
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Nurse
Registered: 02/28/08
Posts: 7

    09/19/08 at 02:27 PM
  Reply with quote#1
This question pertains to the time out process for coronary artery bypass graft (CABG). A physician assistant harvests the vein from a leg, prepares the vein, then the surgeon scrubs in and opens the chest. The vein harvesting takes some time---that’s why the surgeon doesn’t open the chest right away. I observed a cardiac surgeon doing the Time Out while the leg was being prepped and draped. It seems reasonable to do the Time Out prior to vein harvesting as long as the entire team is in the room and paying attention.
 
What are other LifeWings trained hospitals doing with regard to a CABG Time Out?
 
Heart cases have a central line insertion by anesthesia after anesthesia induction but prior to the case starting. Ideally, a Time Out should be conducted by the anesthesiologist and nurse prior to proceeding, resulting in a lot of time outs if one is also done before the chest is opened. It would be helpful to know what other hospitals are doing.
 
Doctor
Registered: 02/28/08
Posts: 4

    10/08/08 at 11:39 AM
  Reply with quote#2

Joint Commission Guidance on Secondary Timeouts

 

 

Same physician/ same patient – Multiple concurrent procedures:

            One time out would occur just before starting the procedures.

 

                                                            – Multiple non concurrent procedures:

     Each procedure would require a time out.

 

New member joins the team to conduct a secondary procedure:

            A time out must be done prior to the start of the secondary procedure and it must involve the new member of the team.

 

“If at any time the team members change or the procedure is interrupted it is in the best interest of patient safety to conduct a time out to insure that the entire team is informed about the patient and the procedure.”

 

                                                                       Joint Commission Guidance
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