Promoting patient safety is the fundamental role of health care, yet care-related adverse
events can be disastrous for patients, families and health settings. Surgical patient safety is
still challenge in operation, in spite of the development of the Universal Protocol. Objective:
Assess orthopedic patients' safety in the operating room. Setting: The operating rooms at El-
Hadara University Hospital in Alexandria, Egypt. Subjects: 200 intra-operative patients
undergoing orthopedic surgery and all surgeons (N=10), anesthetists (N=4) and nurses
(N=28). Tool: Surgical Safety Checklist administered to assess operating team practices
comprises a pre-operative verification process, sign in, time out, and sign out. Results: The
findings revealed that the highest performance items of the operating team were related to
patient ID, surgical site marked, patient consent, images, supplies, antibiotics given, and
sterile instruments check; the worst performance items were assessing patient for risk of
excessive blood loss and difficulty of airway or aspiration (62% and 57%,
respectively).Reviewing the key concerns for recovery was undertaken for only 62% of
patients. The results also imply that the differences between parts of surgical safety and
patients' age, as well as types of surgeries, were statistically significant. Conclusion: The
high mean score of surgical safety applied by operating team was related to phase I
(preoperative verification) and phase IV (sign out). Recommendations: The findings
highlight the need for using Surgical Safety Checklist in the operating room to maintain safety
culture and prevent complications.