I LOVE TO COUNT
The name of the count used as the baseline and must be done before the procedure starts
What is the INITIAL count
This layer of the wound cannot be closed until all counts are verified correct
What is final skin closure
This is the number by which we count all instruments, sponges, sharps and miscellaneous items during the counts
What is the number "ONE by ONE" or by "Each"
SEPERATE, POINT OUT, VISUALLY VERIFY EACH COUNTED ITEM TOGETHER. COUNT ITEMS AUDIBLY as VISUALIZED.
Never do this to packing material before it is inserted
What is "PRE-CUT"
A complex and high-risk task associated with risk for human error that you do for every case that when it is not performed in a standardized process free of distractions can lead to a patient injury or death
What is the surgical COUNT
The two persons responsible to perform all counts
Who is the RN and Scrub Person
All sponges off the sterile field are placed here before performing counts
What is the pocketed sponge bag holder
We count all these things for all GYN cases prior to the start of the procedure and upon closure of the peritoneal cavity
What are sponges, sharps, miscellaneous items and instruments
A purple armband for each one of these type packings is applied to the patient
What is vaginal packing
Name of the reportable patient safety event that can result in serious patient injury or death e.g. retention of an unintended retained surgical item such as broken wire, retained sponge, balloon fragment etc...
What is a Sentinel Event or Never Event
When counting pre-packaged items you verify if the count of the packaged item matches this on the package label.
What is the "correct manufacturer's quantity"
The doctor must "sweep" this at the end of the procedure if any item was inserted, placed or packed in it during the surgery
What is an orifice or cavity
This is never an acceptable practice to reconcile an incorrect count whether the count is over or under the expected number
What is counting the number of packages opened
or
What is memory or recall
This must be counted and documented when placing a wound vac
What are the "number of foam sponge pieces" under the vi-drape
and
any packed items under the foam e.g. white foam, adaptic pieces
Items inserted during the procedure, that are intended to be removed before the end of the procedure get documented on this as a visual safety check for removal
What is the count board
You must "verify" this when accounting for each counted sponge to ensure patient safety and accuracy of the count
What is the radiopaque marker
The phase of Universal Protocol when all procedure counts, packings and sweeps are reviewed with the surgeon for patient safety
What is the DEBRIEF!
We take this action to seek additional help and guidance and provide notification when any adverse event such as an incorrect count or an unintended retained item occurs
What is Chain of Command
The phase of Universal Protocol in which a final review of intentional packing material number, type and location are verified with the surgeon
What is the Debrief
During the procedure, we VERIFY this for ALL items before use and after use for the patient's safety e.g. guidewires, needles, instruments, sheaths, etc...
What is verify the item to be INTACT
I have read and know I am accountable to follow this when performing all procedural counts
What is Lucidoc Count Procedure: Sponge, Sharps, Instrument Counts and Accountability
Counts should not be performed before this is accomplished on the back table in order to prevent risk of count errors
What is "get the back table organized"
Per hospital procedure, who can be documented as the licensed practitioner as having read and confirmed an X-ray for the purpose of an incorrect count or potential broken or retained item?
Who is the "Radiologist or Surgeon"
NOTE: Make sure if it is the surgeon who reads the film, they confirm permission for you to document them as the physician of record who cleared the film and then they need to make a post-op note to indicate no unintended retained item was seen. Otherwise, you should wait on the radiologist's reading.
Three places packing materials are documented
(exclude peritoneal cavity packing)
What is iView, Procedure Record, and wound dressing (labeled)
Miscellaneous items newly added to the count for all TAVR procedures
What are Guidewires, Sheaths, Micro-introducers, and Dilators