Ask HRC: Standards for Marking Surgical Sites

A Healthcare Risk Control System (HRC) member recently asked if there are any standards or references that discourage marking surgical sites with either an “L” or an “R” to indicate the site or side for a surgical procedure. ECRI Institute has done extensive work on wrong-site surgery as a contractor to the Pennsylvania Patient Safety Authority, which has published numerous reports on wrong-site surgery based on events and near misses reported by Pennsylvania hospitals under the Pennsylvania Patient Safety Reporting System (PSRS). Our PSRS team is unaware of a standard that addresses the use of R and L when identifying a site or side for surgery. Each facility should establish its own policy for marking the site; however, the policy must be consistently adhered to by everyone. Additionally, the mark should indicate the surgical site (in other words, the mark should not be used to indicate, for example, “not this side”).

The Patient Safety Authority’s recommendations are summarized in its Principles for Reliable Performance of Correct-Site Surgery (which is available online at [http://patientsafetyauthority.org/EducationalTools/ ...