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Tools of the Trade
Points of Interest
MIA
Tally Ho
Mixed Reviews
100
This item should be used instead of laps, towels or malleable retractors when closing the abdominal cavity.
What is Visceral Retainer (fish)
100
When a needle or suture pack is opened onto the sterile field, the scrub and circulator must do this.
What is verify the number of needles.
100
Linen and this must stay in the OR from the initial count until after the final count has been reported as correct?
What is the trash. (All counted items are removed from the OR at the end of the procedure)
100
When you are using radio-frequency detection scan this is still required.
What is a count. (RF scanning is an adjunct to counting and does not replace the manual count process)
100
All counts are done by these team members.
Who are the circulator and the scrub (at least 1 must be RN)
200
Instruments will be counted when this is or could be entered.
What is body cavity. (incision 3" or larger)
200
Sharps to be counted. (name 3)
What are: cautery tips, knife blades, hypodermic needles, suture needles (others as determined by team, ie: scoville needle on open procedures)
200
In the event of an incorrect count, who needs to be notified?
Who is the staff surgeon, charge nurse, radiology for xray to rule out retained foreign body.
200
What must the scrub do to the sponge pack when counting with the circulator?
What is break the band and separate the sponges while counting so that both team members can see the items.
200
This should be done prior to using the RF mat/wand daily.
What is an initial scan.
300
A limited instrument count would include these. (name 5)
What are: temporary aneurysm clips, dietrich bulldogs,, potts bulldogs, fistula tips, coronary artery occluders, femoral trial heads, s & t vascular clamps, titus needles, varus needles, yassergils
300
This needs to be done prior to sealing the red sharps box when it becomes full.
What is ...items counted by 2 staff members, sealed and removed from surgical field, circulator label with number & types of items contained, then remove from count sheet
300
This must be done if have incorrect counted item, xray taken due to incorrect count or an unintentionally retained counted item is removed.
What is a PSN.
300
When using a throat pack, this must be done...
What is activate the "throat pack in" sign on the OR door. It stays this way until the throat pack is removed.
300
Counts are performed at the following times...
What are... 1. prior to the beginning of the procedure. 2. closure of any cavity. 3. initial wound closure. 4. start of skin closure. 5. permanent relief of either the scrub or circulator. 6. whenever any surgical team member feels the need for a count.
400
These procedures a FULL instrument count is done at initial closure.
What are: chest or abdominal surgery with incision greater than 3"
400
An xray should be taken for a missing needle larger than this length?
What is 17mm.
400
Wound closure must STOP during search for missing item and the patient must remain this?
What is anesthetized and draped until the radiology report is obtained. (Radiologist must phone results to surgeon)
400
When a sponge count bag is used this must be done...
What is place one sponge in each compartment for visualization during the count. Bagged sponges must be verified by 2 staff members (1 must be RN) prior to removing from count. Additionally: when throwing sponges off surgical field they should be opened completely: sponges should be thrown off in original package numbers. ie: laps-5, raytec-10
400
This must be done when skin closure is complete.
What is a radiofrequency scan (mat or wand). When wanding make sure to do a vertical and horizontal scan. Also-remember to chart your confirmation code in Epic.
500
This should be inspected and/or counted when instruments have removable pieces.
What are: yankeur suction tips, screws on instruments, blades of self-retaining retractors.
500
What should NOT be used to verify the needle count if needed?
What is the suture package.
500
Where you document if sponges are intentionally left in a wound.
Where are Epic under count comments and nursing notes. (Remember log#)
500
This should be included on the appropriate count worksheet/card.
What are the patient name and hospital number. (zebra label)
500
Defined as the time at which the patient is discharged from the OR or the time at which the patient is extubated, whichever occurs first.
What is Surgery End Time or After Surgery.