Endoscopy Specific Patient Safety Time Out Calls for

Endoscopy Specific Patient Safety Time Out Calls for: Time-out (all activities cease) · Introductions ·Plans for Sedation Provider RN/ Tech Anesthesia (as applicable) I have confirmed two patient identifiers, I have verified that this is ______ with MRN/DOB ______. I have verified that she/he has consented for (reads from consent): · Procedure · Fire assessment score is _____ I have confirmed: · Allergies; · Plan for sedation (as applicable if not mentioned by Provider) · Imaging on screen is for this patient (Provation) · All required equipment is present and functioning properly From anesthesia record: · Patient name and MRN/DOB____ · Allergies · Anesthesia Plan (Nurse reports and Anesthesia agrees) · Airway/other concerns · Antibiotic ______ dose ______ at _____ · · Provider · · · Procedure As applicable: Confirms use of implants and/or special equipment (as applicable). Our patients expect each of us to speak up about safety concerns now and during the procedure. What concerns do you have? Time out is complete. End of Procedure Debrief RN & Provider · · · Specific procedure(s) done. The Immediate Post Procedure Note will be completed by _____. Specimens sent and tests ordered (as applicable). Medication totals. Special considerations for this patient. What went well/ any opportunities for improvement?