Case Cart Assembly Verification Log

Verifies case cart contents against the pick list in the SPD staging area before transport to the OR, documenting completeness, accuracy, and readiness for release.

Verification Details

• Case cart ID recorded
  Enter the unique case cart identifier or cart number.
• Procedure / service line recorded
  Enter the scheduled procedure, service line, or case name tied to the pick list.
• Pick list version or date matches current case
  Record the pick list version, date, or reference used for verification.
• Verification completed in SPD staging area before OR transport
  Confirm the cart was checked at the designated staging location before release.

Contents Match Pick List

• Required instruments present
  All instrument sets and individual instruments listed on the pick list are present.
• Required disposable supplies present
  All disposable supplies, drapes, dressings, and consumables listed on the pick list are present.
• Required implants or special-order items present
  Any implants, loaner items, or special-order items listed on the pick list are present and accounted for.
• Quantity matches pick list
  Quantities of each item match the pick list with no shortages or overages.
• Substitutions or omissions documented
  Any substitution, omission, or backorder is documented and communicated per facility process.

Package Integrity and Sterility

• Packaging intact and undamaged
  Outer packaging, wrappers, and seals are intact with no tears, punctures, moisture, or compromise.
• Sterile barrier maintained where applicable
  Sterile items remain within intact sterile barrier systems and are suitable for release.
• Expiration dates verified where applicable
  Any dated supplies, implants, or sterile items are within expiration and not beyond use date.

Cart Readiness and Release

• Cart is organized and secure for transport
  Items are secured to prevent shifting, damage, or contamination during transport.
• Cart label and destination are correct
  Cart identification, case destination, and routing information are correct and legible.
• Released for OR transport
  Cart is approved for transport only after all required items are verified and discrepancies resolved.

Inspector Attestation

• Inspector name
  Enter the name of the staff member completing the verification.
• Verification timestamp
  Record the date and time the case cart verification was completed.
• Inspector signature
  Signature confirms the cart was verified against the pick list and released according to facility process.