Free Pre-Surgery Checklist

Patient Information

Pre-Surgery Instructions

• Confirm fasting status: Ensure patient has fasted for at least 8 hours before surgery.

• Medications review: Verify patient has stopped taking blood thinners as per doctor's instructions.

• Confirm laboratory results: Ensure blood tests are completed and reviewed (e.g., CBC, liver function).

• Pre-operative imaging: Confirm that necessary scans (e.g., ultrasound, X-ray) are completed and reviewed.

• Consent signed: Confirm patient has signed all required consent forms.

Equipment and Supplies Readiness

Surgical Team Preparedness

• Surgeon confirmed: Dr. [YOUR NAME] will perform the procedure.

• Anesthesia review: Anesthesiologist confirmed and anesthesia plan discussed.

• Nursing staff informed: All staff assigned to the surgery are briefed on roles and patient information.

• Surgical site marked: Verify correct site marking on the patient.

• Emergency protocol reviewed: All emergency procedures reviewed with the team.

Post-Operative Care Plan

Contact Information

[YOUR COMPANY NAME]
[YOUR COMPANY ADDRESS]
[YOUR COMPANY EMAIL]
[YOUR COMPANY NUMBER]

Please ensure that all items on this checklist are completed to ensure the smooth and safe conduct of the surgery. If you have any questions or need further clarification, feel free to contact us at [YOUR COMPANY EMAIL] or [YOUR COMPANY NUMBER].

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