Developed by

  • Queensland Health
  • Statewide Anaesthesia and Perioperative Network (SWAPNet)
  • Patient Safety and Quality Improvement Service (PSQIS)

Recommended by

Queensland Surgical Services Clinical Network


Clinical pathway

Use this form to assess patients having day surgery, or extended day surgery in hospital.

Day surgery clinical pathway (PDF 861 kB)


Pre-operative screening tools

Use these screening tools before a patient has surgery or a procedure. You can record information about their health, any past illness, surgery, stays in hospital or medicines they take.


Pre-operative checklist

Our perioperative patient record – surgical safety and pre-operative checklist (PDF 976 kB) helps health professionals record and confirm information about a patient who is having surgery or a procedure.

It supports the transfer of patient care and information between health professionals who:

  • are in the ward and admissions area
  • admit patients to the perioperative department
  • will be in the operating theatre.

Read our pre-operative checklist help guide (PDF 347 kB) to learn more.


Use of medical devices and prostheses

This document records details of medical devices and prostheses that are implanted, removed or used during a patient's surgery or procedure.

Sterility validation and prosthesis utilisation record (PDF 725 kB)


Perioperative count record

Use the following documents to record the equipment and instruments used during a patient's operation or procedure.

Professional printing

Queensland Health staff can use the Winc managed print service to order professionally printed resources. Talk to your HHS for more information.

Last updated: 9 April 2025