COUNT BASICS
What are two staff members, with at least one being the RN circulator?
This is the count performed before the procedure begins.
What is the initial count?
A count discrepancy occurs. Who must be notified of the count result and variance?
Who is the attending surgeon?
What is the manual count?
If the RF scan is negative, we don't need to perform the manual count.
What is false?
These four broad group of items require manual counting during surgical invasive procedures.
What are radiopaque soft goods, sharps, miscellaneous items, and instruments?
The count occurs before wound closure begins.
What is the closure count?
You are missing a needle. What is the first thing the team should NOT do?
What is simply document the count as incorrect and move on?
For a bariatric patient, which RF scanning method is required?
What are both the body scanner and wand?
The team removes trash and linen bags from the OR before the final count is reconciled.
What counted items and linen/waste containers should remain in the OR until counts are completed and reconciled?
This person is normally the only person who opens and adds items to the count.
Who is the circulating RN?
Name three situations that require a count.
Before the procedure
Relief of scrub person or RN circulator
Before closure of a cavity within a cavity
Before wound closure
Before skin closure/final count
The missing item cannot be found after the search. What imaging is required?
What is an X-ray of the entire operative site in the OR?
When using RF Assure during closure, what happens first?
What is the manual count, followed by the RF scan?
The scrub person counts a package of 4x4 sponges without separating them.
What is incorrect. Count each sponge should be separated and counted audibly?
During the count, the scrub person must ensure that this person can see the items being counted.
Who is the RN Circulator?
A team member requests a count in the middle of the case. Can they do that?
What is yes- any team member can request a count at any time unless performing it would compromise patient safety?
Can fluoroscopy substitute for a plain- film X-ray when there is a count discrepancy?
What is no?
Name two closure stages where RF scanning is performed.
Cavity within a cavity
Cavity closure
Wound closure
Skin closure
Name five items that can be counted as miscellaneous items.
Electrosurgery active electrode blades
Electrosurgery scratch pads
Endostaple reload cartridge
Trocar sealing caps
Umbilical/hernia tapes
Vessel loops
Marking pens
Rulers
Bite Block
A scrub person discovers that an instrument returned from the operative site appears damaged or incomplete. What should happen?
What is immediately notify the OR team and verify whether the item has broken or separated within the surgical site?
The surgeon announces, "I'm ready to close." What should happen next?
What is the RN circulator notifies the entire team, the team acknowledges the count notification, and the surgeon performs a methodical examination of the wound/body cavity?
The count is incorrect. The surgeon wants to close because the patient is becoming unstable. What does the policy allow?
What is closure without completing the count/X-ray if the attending surgeon determines that continuing would jeopardize the patient's welfare, followed by X-ray as soon as the patient's condition permits?
The patient has temporary pacing wires. Before scanning, what must the RN do?
What is announce audibly that the scan is about to occur and obtain acknowledgement from anesthesia?
Radiographs will not be required for needle size
What is 10mm of less?