It's Policy
The surgeon closes the surgical site and item is found in cavity, this is an example of a __________________ event.
What is a sentinel event
What is to notify the surgical team in the OR, notify the charge nurse and leader, pause surgical case until item is found.
The initial count should be done
What is before the patient enters the room
The patient is scheduled for a colorectal surgery, what is the process for setup and counts
What is a clean and dirty set up with separate counts
An example of a countable miscellaneous item
What is vessel loops, suture booties, cottonoids, scratch pads, kittners
What is a separate count is done for each side/site
The surgical team is identified and are unable to find missing sponge, what is the next intervention
What is to have a two opposing view X-ray of the entire operative site will be taken before continuing with closure read by a radiologist
Example of anesthesia role in surgical count
What is throat pack, bite block, and any other object from the oropharynx and communicated to the surgical team.
Who is responsible for speaking up if there is a discrepancy in the surgical count?
What is any member of the surgical team
The best device to help in aiding visualization of sponges
what is surgical sponge counter bags
An intraoperative/procedural death has occurred, the surgical team must perform _____________ before patient leaves the OR
What is all surgical counts
A nurse and scrub tech provide permanent relief for a case, what needs to be done
What is a permanent relief count is done with nurse and tech
There is a count discrepancy, when can the surgeon finish the closure of the surgical site
What is until report is received from the radiologist
If a radiologist is not available to read an x-ray for an incorrect surgical count, who can?
What is the surgeon, the radiologist will render a final interpretation
The surgical count starts with_______, _______, _____________, and ends with ____________ if applicable
What is... sponge, sharps, miscellaneous items, and then instruments
What is before patient arrival and end of procedure
The location counts are documented for the entire surgical team to see
What is the white board
What is sponge, sharps, miscellaneous items and instruments
The ___________ and _____________ are responsible of the location of all countable items in the surgical site.
What is the surgeon and first assist
The times to count are as follows
What is Before the procedure, closure of a cavity within a cavity, before wound closure begins, at skin closure or end of procedure
The surgeon or proceduralist determines the patients condition is deteriorating and the surgical count is not correct, what to do?
What is the final counts may be resolved by a two opposing view x-ray of the operative field at the next level of care (ICU, PACU).
In cases of extreme patient emergency that necessitate omission of a preprocedural/procedural count
What is a post-operative two opposing view x-ray will be obtained of the operative site before the patient leaves the OR/procedure room.
what is when the patient is returned back to a supine position. There is another sponge count performed
If the count remains incorrect after all the steps to locate the missing item(s) have been exhausted
What is the Circulating Nurse will document on the Intraoperative Record "unresolved”, the actions that were taken and the time the actions were taken. Document radiologist that read the x-ray and findings
Count discrepancy and meeting resistance from the surgeon.
What is call for charge nurse and leader