Policy
What should be minimized during counts so they can be done effectively?
What are distractions, noise, and unnecessary interruptions
When are instruments counted for a case?
What is when the likelihood exists that an instrument can be retained
What count includes all countable items and is done prior to the start of the procedure?
What is the initial count?
What is a SERS?
What is a Safety Event Report
Every count must be performed in the same manner to ensure accuracy and continuity, what is the sequence of the count?
What is - surgical site to immediate surrounding area; mayo stand, back table; items that have been discarded from the field
What is the process for counting items?
What is audibly and concurrently, separated, counted by 2 caregivers, one needs to be an RN
When are sponges counted for a case?
What is an initial count is done before the case starts and on ALL procedures where countable sponges are used
What count is done when the scrub and/or circulator is permanently relieved?
What is the relief count
What injuries need Reported by a SERS?
What is death, brain or spinal damage, permanent disfigurement, fracture or dislocation of bones or joints, neurological, physical, or sensory limitation that continues after discharge
When items are added to the surgical field who do they need to come through to ensure they are counted?
Who is the surgical scrub
What is done with items that are introduced to the field during the case or used in a manner that might not be readily seen?
What is noted on the count board or written on the back table cover
When are sharps counted?
What is on all cases
What count starts during the closure of the peritoneum, fascia, wound or at the conclusion of each procedure for cases involving multiple procedures?
What is Closing or Working count
What surgical situations need to be reported with a SERS
What is wrong patient, wrong procedure, wrong site, or a surgical procedure otherwise unrelated to patient's diagnosis or medical condition
What communication technique should be used when it is necessary to ensure the team is aware of counted items when they are placed in such a way that the item is obscured from view? example packing with a lap
What is closed loop communication
What is done with counted items when there is a manufacturer defect in packaging- only 4 laps in a pack of 5
What is remove the items from the room
bonus points: make your charge nurse aware of the situation
there are really no bonus points
If a countable item is altered or cut what must the surgical team ensure?
What is the item must be accounted for in their entirety
What count begins prior to sternal, subcutaneous, or skin closure and requires all surgical activity to stop?
What is the final count
How does Florida Statutes define an adverse incident?
What is an incident which health care personnel could exercise control over
What is done with broken sharps, instruments, or devices that might have caused or have caused patient injury?
What is sequestered and reported per the Florida Medical Device sequester procedure
What should you do if you are not familiar with or have not been educated on a tray, procedure, or equipment?
What is Speak up
If items are added to the sterile field during a case what must happen with them?
What is count them, add them to the count, document them on the count sheet, white board is best so the entire team can be aware
What count is the last required count, starts prior to the last skin stitch or staple, accounts for all closing instruments, soft goods, and miscellaneous items
Reconciled count
True or False - a procedure to remove unplanned foreign object remaining from a surgical procedure require completion of a SERS.
What is true
What is the first step to do it there is an incorrect count ?
What is notify the staff surgeon and is asked to inspect the wound and sterile field, then the count is repeated