Preoperative Checklist

Use our preoperative checklist template as a starting point to customize yours to fit your practice.

Preoperative Checklist

What are the Benefits of Using this Preoperative Checklist?

  1. It Enhances Patient Safety and Preparation

    Thoroughly prepare for surgical procedures by systematically organizing and verifying essential details, ensuring patient safety and well-being.

  2. It Improves Operational Efficiency

    The checklist assists medical professionals in streamlining preoperative processes, reducing the risk of oversights, and optimizing the utilization of resources.

  3. It Facilitates Communication and Collaboration

    Enhance communication within surgical teams by providing a structured approach to discuss patient-specific considerations, potential challenges, and the surgical plan.

  4. It Ensures Informed Decision-Making

    Utilize the checklist to review patient medical history, allergies, and current medications, allowing for informed decisions and tailored patient care.

The All-In-One Employee Management App That Sets Your Business Up For Success

Forms & checklists, scheduling, time tracking, communications, HR, and so much more — 100% free for up to 10 users.

Connecteam’s smart Forms & Checklists feature already helps over 36,000 businesses increase productivity and oversee frontline teams.

  • Quickly create custom forms or save time with pre-made templates
  • Receive instant information and feedback from the field
  • Increase accountability with eSignatures and geolocation
  • Get notifications when employees check off items, sign documents, or upload a form
  • Easily export and share reports within your organization

Digital Forms is the New Norm

Easily create and publish custom forms from the field

The Preoperative Checklist is an essential tool designed to ensure thorough preparation before surgical procedures.

This checklist assists medical professionals and surgical teams in systematically organizing and verifying crucial details, enhancing patient safety, operational efficiency, and communication.

By utilizing this checklist, you can proactively address key aspects, reducing the risk of oversights and ensuring a smooth transition into the operating room.

Preoperative Checklist:

Patient Information:

[  ] Verify patient identity using two identifiers (e.g., name, date of birth).

[  ] Confirm surgical procedure and site based on the patient’s consent and medical records.

[  ] Review patient’s medical history, allergies, and current medications.

[  ] Assess any preoperative tests and diagnostic results.

Informed Consent:

[  ] Ensure that the patient has signed a valid informed consent form for the intended procedure.

[  ] Address any questions or concerns the patient may have regarding the surgery.

Preoperative Testing:

[  ] Confirm completion and review of any required preoperative tests (e.g., blood work, imaging).

[  ] Ensure necessary consults (e.g., anesthesiology, cardiology) have been conducted.

Anesthesia Evaluation:

[  ] Anesthesia evaluation completed by an anesthesiologist or anesthesia provider.

[  ] Discuss anesthesia plan, potential risks, and any patient concerns.

Patient Preparation:

[  ] Provide patient with preoperative instructions (e.g., fasting, medication guidelines).

[  ] Ensure patient has removed any jewelry, contact lenses, and prosthetics.

Surgical Site Preparation:

[  ] Mark the surgical site as appropriate, and confirm it matches the patient’s consent.

[  ] Ensure proper skin antisepsis has been performed in accordance with guidelines.

Team Briefing:

[  ] Conduct a team briefing to review the surgical plan, patient-specific considerations, and any potential challenges.

[  ] Verify that all necessary team members (surgeons, nurses, anesthesiologists) are present and informed.

Equipment and Supplies:

[  ] Verify availability of necessary surgical instruments, implants, and equipment.

[  ] Ensure all equipment is properly sterilized and functional.


[  ] Document preoperative activities, patient discussions, and completed checklists.

[  ] Review and sign off on the preoperative checklist.

The Preoperative Checklist serves as a critical component of ensuring patient safety and optimal surgical outcomes. By meticulously addressing patient information, informed consent, preparation, and communication, medical professionals can pave the way for a successful surgery. Utilize this checklist to methodically approach preoperative tasks, collaborate effectively with the surgical team, and enhance the overall quality of patient care.

Choose Connecteam, the #1 Choice for Medical Practices

Revolutionize your medical practice’s daily operations and unleash unparalleled safety with Connecteam!

Take charge with our Forms and Checklists feature, effortlessly preparing your team for surgeries and delivering the highest standards. But that’s just the beginning! 

Easily create perfect employee schedules with our dynamic Scheduler, enabling seamless staff organization and maximizing productivity. Keep a tight grip on employee work times using our Time Clock feature, making precise payroll a breeze and freeing you from mundane administrative tasks.

Stay ahead of the game with Connecteam’s built-in employee Chat, fostering real-time collaboration and empowering your team to deliver extraordinary results.

And don’t forget, continuous growth and skill development are at your fingertips with Connecteam’s comprehensive Training & Onboarding features.

Get started with Connecteam for free today and unlock the true potential of your medical team!

Embrace Efficiency, or Stick with Pen & Paper?

Discover the Power of Connecteam – Distribute Hand-Tailored Forms and Checklists to Your Entire Workforce with Just a Few Clicks.

Join Connecteam Today and Experience Seamless Management – It’s Absolutely Free!

Download PDF