Making it count in surgery
Purpose: To prevent retained items in Surgical Procedures
Thesis: My goal is to inform my audience the importance of counting the instruments and sterile supplies for Surgical Procedures.
Organizational Pattern: Topical
A. Attention Getter: Have you ever heard of someone having a sponge left inside them from surgery? When this happens, it’s because staff did not count correctly. A retained object can cause a patient pain, severe infection, additional surgical procedures and even death.
B. Relevance: According to Joint Commission statistics, Retained Surgical Items are the most reported ...view middle of the document...
2. Another patient at risk is the obese patient.
a. When operating on an obese patient the hole is longer and deeper, so there is a lot more area to lose stuff in.
b. Sponges get wet with blood and can begin to look like tissue.
c. Searching for a sponge is tougher, before of the depth.
d. X-Rays must encompass the entire abdominal cavity if an abdominal surgery.
3. The third risk for patients is a staff change.
a. Staff must count items when trading out.
b. Many times a miscount involves staff that has already left. We may have to get them on speaker phone in the room.
Transition: So it stands to reason an obese patient who is having an emergency procedure with a staff reliefs taking place, is at risk of a retained foreign body. But what do we do every day to prevent retained items in the operating room?
B. We COUNT!!!
1. We count prior to the procedure.
2. Ideally before the patient arrives.
a. All instruments are counted.
1. We remove instruments from the instrument basket.
2. There is a count sheet in each instrument pan.
3. TWO staff members, one being the RN and one the Scrub technologist count each item and it is marked on the count sheet as we go.
b. All sponges are counted
1. We have 4inch by 4 inch gauze sponges and laparotomy sponges
2. They are separated and counted
c. Any other items
1. There are cautery tips, pens, syringes, any tidbits that go on the field is counted
3. During the procedure as items are added, we count them and add them to a running count.
4. If there is permanent staff relief, a count takes place.
5. When the procedure is over, we count.
a. We count anytime a body cavity is being closed, such as the peritoneum. And we will count again once it is closed.
b. The last count is called the final count.