Surgical counting is the process of counting all surgical items before, during, and at the end of a surgical procedure to ensure that there are no items left inside the patient. If there is no possibility of an item being retained, there is no need for a surgical count. Both counting nurses must agree that a count is not required and the surgeon and surgical team should be informed that no count will be completed for that procedure. Two nurses perform the surgical count, one of whom will be a nurse nurse.
Whenever possible, the same two nurses are responsible for all surgical counts during the procedure. The nurse in charge shall ensure that the instrumental nurse responsible for the surgical counting is not required to act as a surgical assistant in operating procedures in which a body cavity is opened. If, in an emergency situation, it becomes vital to do so, the surgeon will allow time for the instrument nurse to complete the count. In addition, opportunities for innovation in performing surgical counting should be considered, particularly in light of the fact that, since its inception, little time and effort has been devoted to developing a more reliable method of checking retained surgical articles other than manual counting.
Surgeons and nurses must commit to common patient safety goals to ensure that surgical instruments, sponges and sutures are not retained in the patient's surgical wound. Although this study was conducted using nurses as key informants, the perspectives of other surgical team members, such as surgeons, anesthetists and technicians, could shed more light on how power relationships affect surgical outcomes. At the beginning of a surgical procedure, nurses manually counted the number of disposable items or surgical supplies that could be discarded at the end of the case, and the instruments, and recorded the count on a purpose-designed “count sheet”. In these cases, the role of the instrument nurse, with responsibility for performing a count at certain stages of the surgical procedure, could be considered secondary to the need for surgical assistance.