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Time Out Announcement 2nd Counting

• Good morning/afternoon, ready for timeout, this is patient • Ready for 2nd counting. *Scrub nurse counts*
(name, age, sex) • 2nd count, all sponges, instruments, and needles are
______________________________________, ____, ____, complete.
with a diagnosis of ____________________________ for the Sign Out Announcement
procedure of ______________________________________ Good Morning/Afternoon
________________________________________________. • Surgeon (Dr./Dra.):
• Can all team members please introduce yourselves by stating • 1st Assistant Surgeon (Dr./Dra.):
your name and role. • 2nd Assistant Surgeon (Dr./Dra.):
• *Doctors speak* • 3rd Assistant Surgeon (Dr./Dra.):
• Doctor (Head Surgeon) ___________________________, • Anesthesiologist (Dr./Dra.):
Any anticipated events? ____________________________ • Assistant Anesthesiologist (Dr./Dra.):
Anticipated blood loss? _____________________________ • Scrub Nurse (Ma’am/Sir):
Expected duration of the procedure? ___________________ • Student Scrub Nurse (Mr/Ms):
• Doctor (Anesth) ______________, any specific concerns po? • Circulating Nurse (Ma’am/Sir):
• Ma’am/Sir (SN/SSN) ________________, please confirm the • Student Circulating Nurse (Mr/Ms):
sterility of the instruments. • CI (Sir/Ma’am):
• Ma’am/Sir (SN/SSN) ________________, initial counting po. • *Student Head Nurse (Ma’am/Sir)
• *Scrub Nurse Counts*
• I’m (Your Name) student nurse from Nueva Ecija University
• _______ Set, Initial count, complete.
of Science and Technology, Batch 2024. Announcing that all
sponges, instruments, and needles are complete.

Time Out Announcement 2nd Counting


• Good morning/afternoon, ready for timeout, this is patient • Ready for 2nd counting. *Scrub nurse counts*
(name, age, sex) • 2nd count, all sponges, instruments, and needles are
______________________________________, ____, ____, complete.
with a diagnosis of ____________________________ for the Sign Out Announcement
procedure of ______________________________________ Good Morning/Afternoon
________________________________________________. • Surgeon (Dr./Dra.):
• Can all team members please introduce yourselves by stating • 1st Assistant Surgeon (Dr./Dra.):
your name and role. • 2nd Assistant Surgeon (Dr./Dra.):
• *Doctors speak* • 3rd Assistant Surgeon (Dr./Dra.):
• Doctor (Head Surgeon) ___________________________, • Anesthesiologist (Dr./Dra.):
Any anticipated events? ____________________________ • Assistant Anesthesiologist (Dr./Dra.):
Anticipated blood loss? _____________________________ • Scrub Nurse (Ma’am/Sir):
Expected duration of the procedure? ___________________ • Student Scrub Nurse (Mr/Ms):
• Doctor (Anesth) ______________, any specific concerns po? • Circulating Nurse (Ma’am/Sir):
• Ma’am/Sir (SN/SSN) ________________, please confirm the • Student Circulating Nurse (Mr/Ms):
sterility of the instruments. • CI (Sir/Ma’am):
• Ma’am/Sir (SN/SSN) ________________, initial counting po. • *Student Head Nurse (Ma’am/Sir)
• *Scrub Nurse Counts*
• I’m (Your Name) student nurse from Nueva Ecija University
• _______ Set, Initial count, complete.
of Science and Technology, Batch 2024. Announcing that all
sponges, instruments, and needles are complete.

Time Out Announcement 2nd Counting


• Good morning/afternoon, ready for timeout, this is patient • Ready for 2nd counting. *Scrub nurse counts*
(name, age, sex) • 2nd count, all sponges, instruments, and needles are
______________________________________, ____, ____, complete.
with a diagnosis of ____________________________ for the Sign Out Announcement
procedure of ______________________________________ Good Morning/Afternoon
________________________________________________. • Surgeon (Dr./Dra.):
• Can all team members please introduce yourselves by stating • 1st Assistant Surgeon (Dr./Dra.):
your name and role. • 2nd Assistant Surgeon (Dr./Dra.):
• *Doctors speak* • 3rd Assistant Surgeon (Dr./Dra.):
• Doctor (Head Surgeon) ___________________________, • Anesthesiologist (Dr./Dra.):
Any anticipated events? ____________________________ • Assistant Anesthesiologist (Dr./Dra.):
Anticipated blood loss? _____________________________ • Scrub Nurse (Ma’am/Sir):
Expected duration of the procedure? ___________________ • Student Scrub Nurse (Mr/Ms):
• Doctor (Anesth) ______________, any specific concerns po? • Circulating Nurse (Ma’am/Sir):
• Ma’am/Sir (SN/SSN) ________________, please confirm the • Student Circulating Nurse (Mr/Ms):
sterility of the instruments. • CI (Sir/Ma’am):
• Ma’am/Sir (SN/SSN) ________________, initial counting po. • *Student Head Nurse (Ma’am/Sir)
• *Scrub Nurse Counts*
• I’m (Your Name) student nurse from Nueva Ecija University
• _______ Set, Initial count, complete.
of Science and Technology, Batch 2024. Announcing that all
sponges, instruments, and needles are complete.
Time Out Announcement 2nd Counting
• Good morning/afternoon, ready for timeout, this is patient • Ready for 2nd counting. *Scrub nurse counts*
(name, age, sex) • 2nd count, all sponges, instruments, and needles are
______________________________________, ____, ____, complete.
with a diagnosis of ____________________________ for the Sign Out Announcement
procedure of ______________________________________ Good Morning/Afternoon
________________________________________________. • Surgeon (Dr./Dra.):
• Can all team members please introduce yourselves by stating • 1st Assistant Surgeon (Dr./Dra.):
your name and role. • 2nd Assistant Surgeon (Dr./Dra.):
• *Doctors speak* • 3rd Assistant Surgeon (Dr./Dra.):
• Doctor (Head Surgeon) ___________________________, • Anesthesiologist (Dr./Dra.):
Any anticipated events? ____________________________ • Assistant Anesthesiologist (Dr./Dra.):
Anticipated blood loss? _____________________________ • Scrub Nurse (Ma’am/Sir):
Expected duration of the procedure? ___________________ • Student Scrub Nurse (Mr/Ms):
• Doctor (Anesth) ______________, any specific concerns po? • Circulating Nurse (Ma’am/Sir):
• Ma’am/Sir (SN/SSN) ________________, please confirm the • Student Circulating Nurse (Mr/Ms):
sterility of the instruments. • CI (Sir/Ma’am):
• Ma’am/Sir (SN/SSN) ________________, initial counting po. • *Student Head Nurse (Ma’am/Sir)
• *Scrub Nurse Counts*
• I’m (Your Name) student nurse from Nueva Ecija University
• _______ Set, Initial count, complete.
of Science and Technology, Batch 2024. Announcing that all
sponges, instruments, and needles are complete.

Time Out Announcement 2nd Counting


• Good morning/afternoon, ready for timeout, this is patient • Ready for 2nd counting. *Scrub nurse counts*
(name, age, sex) • 2nd count, all sponges, instruments, and needles are
______________________________________, ____, ____, complete.
with a diagnosis of ____________________________ for the Sign Out Announcement
procedure of ______________________________________ Good Morning/Afternoon
________________________________________________. • Surgeon (Dr./Dra.):
• Can all team members please introduce yourselves by stating • 1st Assistant Surgeon (Dr./Dra.):
your name and role. • 2nd Assistant Surgeon (Dr./Dra.):
• *Doctors speak* • 3rd Assistant Surgeon (Dr./Dra.):
• Doctor (Head Surgeon) ___________________________, • Anesthesiologist (Dr./Dra.):
Any anticipated events? ____________________________ • Assistant Anesthesiologist (Dr./Dra.):
Anticipated blood loss? _____________________________ • Scrub Nurse (Ma’am/Sir):
Expected duration of the procedure? ___________________ • Student Scrub Nurse (Mr/Ms):
• Doctor (Anesth) ______________, any specific concerns po? • Circulating Nurse (Ma’am/Sir):
• Ma’am/Sir (SN/SSN) ________________, please confirm the • Student Circulating Nurse (Mr/Ms):
sterility of the instruments. • CI (Sir/Ma’am):
• Ma’am/Sir (SN/SSN) ________________, initial counting po. • *Student Head Nurse (Ma’am/Sir)
• *Scrub Nurse Counts*
• I’m (Your Name) student nurse from Nueva Ecija University
• _______ Set, Initial count, complete.
of Science and Technology, Batch 2024. Announcing that all
sponges, instruments, and needles are complete.

Time Out Announcement 2nd Counting


• Good morning/afternoon, ready for timeout, this is patient • Ready for 2nd counting. *Scrub nurse counts*
(name, age, sex) • 2nd count, all sponges, instruments, and needles are
______________________________________, ____, ____, complete.
with a diagnosis of ____________________________ for the Sign Out Announcement
procedure of ______________________________________ Good Morning/Afternoon
________________________________________________. • Surgeon (Dr./Dra.):
• Can all team members please introduce yourselves by stating • 1st Assistant Surgeon (Dr./Dra.):
your name and role. • 2nd Assistant Surgeon (Dr./Dra.):
• *Doctors speak* • 3rd Assistant Surgeon (Dr./Dra.):
• Doctor (Head Surgeon) ___________________________, • Anesthesiologist (Dr./Dra.):
Any anticipated events? ____________________________ • Assistant Anesthesiologist (Dr./Dra.):
Anticipated blood loss? _____________________________ • Scrub Nurse (Ma’am/Sir):
Expected duration of the procedure? ___________________ • Student Scrub Nurse (Mr/Ms):
• Doctor (Anesth) ______________, any specific concerns po? • Circulating Nurse (Ma’am/Sir):
• Ma’am/Sir (SN/SSN) ________________, please confirm the • Student Circulating Nurse (Mr/Ms):
sterility of the instruments. • CI (Sir/Ma’am):
• Ma’am/Sir (SN/SSN) ________________, initial counting po. • *Student Head Nurse (Ma’am/Sir)
• *Scrub Nurse Counts*
• I’m (Your Name) student nurse from Nueva Ecija University
• _______ Set, Initial count, complete.
of Science and Technology, Batch 2024. Announcing that all
sponges, instruments, and needles are complete.

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