Add missing section to paper based on comments (add 2 paragraphs)

Preprocedure Hand-Off

Y N

Identification / allergy armband on patient's arm?

Do Not Resuscitate (DNR) status: ___________________________________________________

Allergies :

Latex allergy?

Isolation Status?

Patient seen by Anesthesia?

Consent form signed?

History & physical on chart?

Lab, chest x-ray, electrocardiogram on chart if ordered?

Medication Administration Record (MAR) / transfer medication form on chart?

Type and screen completed?

Units of blood ordered?

Transport sheet prepared?

Intravenous sites / tubing labeled?

Preop medications given and time? __________________________________________________

Preop antibiotic administered to patient on unit @ what time?_______________________________

Preop antibiotic sent to OR with patient?_______________________________________________

Dentures removed?

Glasses / contacts removed?

Hearing aid removed?

Metal implants? If yes, where?

Jewelry removed or Patient refused to sign "Jewelry Removal" form to be placed on chart?

Clothing / underwear removed?

Primary language is English. If no, primary language is ______________________________________

Patient's contact person /information?

"NPO" (since ________________)

Voided? (@ _________________)

Operative site marked?

Time: Last Vital Signs: Temperature? Blood Pressure?

Respirations? Pulse?

Messages to Operating Room ?________________________________________________________

Nurse HANDING OFF patient : ____________________________Date: _________ Time: _______

Nurse ACCEPTING patient: ____________________________Date: _________ Time: _______