Surgical Counts Policy
When a discrepancy in the count occurs, this is followed to locate the missing item.
What is the Incorrect Count Algorithm process?
Prior to each count interval, the circulating nurse announces to the OR team that the count will be commencing and requests that these will be minimized.
What are distractions?
Also accepted:
Non-essental conversations
Non-urgent requests
Music
Soft goods and miscellaneous items will be counted when this feature of the surgical wound occurs.
What is when the wound is large enough to retain an item in these categories?
Sponge counter bags are filled in this direction.
What is from bottom to top?
When there is a variable count, this is the first thing that occurs.
What is immediately notifying the team of the discrepancy, including type and number of items missing?
This is the purpose of the surgical count policy.
What is prevention of unintentionally retained surgical items (RSI)?
In the event of a life-threatening emergency where counts were aborted, these must be done prior to wound closure if the patient's condition permits.
What are x-rays? (+200 bonus points awarded if AP and lateral views were mentioned)
During closing counts, counts will take place in this order of priority.
What is, from the surgical field, to the mayo stand, the back table, and last from items passed off the field?
Each type of sponge is placed in a separate sponge counter bag. One sponge is placed per one of these.
What is pocket?
+ 200pt bonus for mentioning 10 pockets for Raytecs and 5 pockets for Laps
In the event of a variable count, the surgeon and surgical first assistant does this.
What is stops wound closure, performs methodical wound exploration, and participated in attaining intraoperative imaging?
If the surgical wound is small enough, these are not required.
What is a surgical count?
Only packing with this should be used in the surgical wound.
What is radiopaque marking?
In the event a patient leaves the operating room with an intentionally retained item, the circulator will document that the count is this.
What is correct with intentionally retained foreign objects (IRFO)?
The circulating nurse must inform this person of the count results after each count.
Who is the surgeon?
In the event of a variable count, the circulator will do this.
What is call for assistance, search the room, and recount?
In the event of patient expiration in the operating room, it is still necessary to complete this.
What is surgical count?
If a patient returns to the operating room with intentionally retained items, the expected amount of items per Avatar documentation are removed, x-rays are taken and read as negative, the nurse will document the counts as this.
What is correct?
When an item is temporarily placed in a wound, such as a sponge, the scrub person will notify the nurse. The nurse must then do this.
What is indicate the type, amount, location of the item temporarily placed in the wound on the communication board in the operating room so it is visible to all team members, and on the count sheet?
Kittners should be placed in this to be counted.
What is their original carrier?
In an incorrect count, an x-ray is required in these circumstances.
What is when there is a variable count, an item is cut or broken, the item is not found, and is radiopaque, and when suture needles are 10mm or greater?
Removal of a retained surgical item in the deceased patient is at the discretion of this person.
Who is the surgeon?
These are the seven times a count must be performed.
What is
1.Before the procedure 2.When new items are added to the field 3.Before closure of a cavity within a cavity 4.When wound closure begins 5.At skin closure 6.Permanent relief of scrub or circulator 7.Additional counts when requested by any team member to confirm when discrepancy suspected
Items are counted in this order of priority.
What is soft goods, sharps, miscellaneous items, instruments?
An x-ray is not required for an incorrect suture needle count for needles smaller than this size.
What is 10mm?
If an x-ray is positive for a foreign body, and the item is removed, with counts repeated and now correct, this report must be completed.
What is an Origami Event report?