Clinical Protocol for Cataract Surgery using Medisoft®

If the protocol is not used properly, mistakes can continue to be made or near misses with lens choice.  It is imperative that a clear choice is made by the surgeon that is then subsequently rechecked by another member of the team.  Theatre staff must challenge any surgeon not complying with this guideline.  If not remedied then this must be reported to the line manager and Clinical Lead.

All theatre personnel have a duty to question the surgeon over lens choice / side / patient identity if they have any concerns.

1. The Medisoft® entry for the patient is to be opened BEFORE commencing surgery.
   Check you are opening the correct patient that was sent for AND is already in the anaesthetic room.
2. Open the operation screen and select surgery and side.
3. Open device – biometry: check A-constant; Lens style; Axis and lens power.
4. Select lens and save changes to biometry.  (This will automatically enter the lens and refraction into the operation screen if you have selected the correct side).
5. Identify the Patient name, NHS number, Side and Lens on theatre whiteboard / screen.
6. When the patient identity is checked at “Time Out” they should also check that this matches the identity and side that is open on the Medisoft® screen (and written on the whiteboard).
7. When staff open the lens they should check the power and style and the patient identity and side again against the Medisoft® cataract screen and sign on the WHO surgical checklist that they have done so.
8. Do NOT open multiple patient entries simultaneously for subsequent cases or different surgeons.
9. An exception is secondary lens surgery where there is currently no dedicated Medisoft® surgery screen.  In these cases the biometry screen should be left open with the lens selected so staff are able to double check the patient identity, side, style and lens power against the screen.