Responsibility
Definitions
Timing
Methodology
Pearls
100
Who is responsible for performing surgical counts in the OR or other invasive procedure setting?
Who is the RN circulator and a member of the surgical team scrubbed at the sterile field?
100
What is the best way to prevent surgical items left in the patient upon discharge from the operating room?
What is the surgical count process?
100

Where does the final surgical count start, progress, and then end?

What is at the surgical field, the mayo, the back table, kick bucket, then the count tree?

100
What does the AORN recommendation for performing counts: audibly, visually and concurrently mean?
What is the method of looking at items during the count, counting out loud and counting together?
100
When should dressings that contain gauze sponges be placed on the surgical field?
When all sponge counts have been reconciled as to avoid placing a countable item as a dressing?
200
Who can initiate a surgical count?
Who is anyone on the surgical team when a count needs to be reconciled, or if there is a count discrepancy, or permanent change of shift.
200
What does the acronym RSI stand for?
What is the new term coined by AORN for "retained surgical item"
200

When is it permissable to not perform a final count?

When the surgeon has determined that the time it takes to do a final count may contribute to the loss of life or limb to the patient?

200
What is the method to reconcile counts for sponges and sharps that provide transparency and safety by allowing all members of the surgical team to visualize the count?
What is the white dry erase board in each OR?
200
During a hand assisted/laparoscopic procedure, the best method to prevent RSIs would be to...
What would be to perform counts of all sponges, sharps, instruments and miscellaneous items at the beginning and final counts?
300
In the event of an incorrect count, who needs to be notified?
Who is: The surgeon, charge nurse, and finally radiology for an X-ray to rule out a retained foreign body.
300
What is the "radiopaque" strip on sponges used for?
What is to detect location of the sponge in the body during X-ray to prevent a retained surgical item in the patient?
300

When are surgical instruments counted?

When there is a chance that they could be retained such as in procedures that involve a greater than 1 inch incision in the chest, thoracic, or abdominal cavities?

300
In the event of an incorrect count during an exploratory laparotomy procedure, what two views should the X-ray technician expect to take?
What are the AP and lateral views?
300
Demonstrate counting of sponges with radiopaques strip showing and sponges counted individually in the packaged multiple
Demonstrate the correct counting of sponges
400
In the event of an incorrect count and X-ray, who reads the film before the patient can leave the OR?
Who is the radiologist trained to read X-ray films?
400
What is the meaning of a "never" event per TJC standards?
What is the preventable occurence that can harm to patients such as an RSI?
400
Per AORN standards, when are the six crucial times a count must be performed?
Per AORN standards, when are the six crucial times a count must be performed? What is: 1. At the beginning of a procedure to establish a baseline 2. When new items are added to the sterile field 3. During the final count when there is a cavity within a cavity (i.e. uterus) 4. Fascial closure 5. Skin closure 6. Permanent relief of the surgical team
400
What is the appropriate method to fill the counting bags/tree?
What is from the bottom up with all pockets filled?
400

What is the best method for fasical closure to prevent retention of a surgical instrument: 1. Using a malleable ribbon retractor 2. Having the surgeon place their hand or fingers in the abdomen 3. Utilizing a fisch with the ring visually apparent at all times until removal

What is :3. Utilizing a fisch with the ring visually apparent at all times until removal

500
Who is most affected by a retained surgical item?
Who is the patient as well as everyone on the surgical team
500
What is meant by the term miscellaneous countable item?
What is an item small enough to be retained in the patient during surgery-can be radiopaque or non-radiopaque and must be identified per policy and procedure so that all surgical team members are counting the same item?
500
When is the safest time to perform the final count on a patient in the lithotomy position?
When both legs are lifted out of lithotomy and placed in the supine position?
500
What is documented regarding the surgical count in the patient's intraoperative record?
What is personnel performing the count, what is counted, when the count occurred, correct or incorrect, and actions taken if the count is incorrect?
500

Where does the best surgical team in the universe exist?

What is the surgical team at Mission Hospital, of course?

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