The patient presents prior to a right elbow repair surgery. The surgeon speaks with the patient, answers questions, and obtains informed consent. Prior to leaving, the surgeon states, “Good; your hospital ID bracelet is on your right arm. That will signal to us we have the correct limb.” Which response by the nurse is most appropriate?

Question

The patient presents prior to a right elbow repair surgery. The surgeon speaks with the patient, answers questions, and obtains informed consent. Prior to leaving, the surgeon states, &ldquo;Good; your hospital ID bracelet is on your right arm. That will signal to us we have the correct limb.&rdquo; Which response by the nurse is most appropriate?

Accepted Answer

Remind the surgeon that the correct site should be marked in permanent marker. The nurse must advocate for patient safety. The arm band cannot remain on the right arm because that arm must be properly prepped to prevent surgical site infection. Therefore, the nurse reminds the provider to utilize permanent marker rather than a removable bracelet to mark the correct side. The site should be marked by the surgeon performing the procedure, not the nurse. It is not appropriate to document that informed consent has been signed and the correct site has been identified because the surgeon has not properly identified the limb. Submitting an incident report may be necessary if the surgeon fails to properly identify the laterality prior to surgery. However, submitting an incident report does not protect the patient in the moment, so this is not the appropriate action.

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