Improve the profession to ensure quality patient care. Legislation does not prescribe how counts should be carried out, who should perform them, or even what needs to be done. The law only requires that no foreign bodies be left in patients due to negligence. This standardized language consists of the Perioperative Nursing Dataset (PNDS) and includes perioperative nursing diagnoses, interventions, and outcomes.
The expected outcome relevant to this recommended practice is to ensure that the patient is free of injuries related to retained sponges, instruments and sharps, 13 (8) which is within Outcome O2, The patient is free of signs and symptoms of injury due to foreign objects. The counting sequence must be in a logical progression (e.g., from large to small or from proximal to distal). A standardized counting procedure, following the same sequence, helps achieve accuracy, efficiency and continuity among perioperative team members. Altering a sponge invalidates subsequent counts and increases the risk of a portion being retained in the wound.
The counting sequence must be in a logical progression (e.g., from large to small article size or from proximal to distal of the wound). Accounting for all instruments makes inventory control and patient safety easier. Removing all instruments from the room helps prevent possible incorrect counts in subsequent procedures. Policies and procedures also aid in the development of patient safety, quality assessment, and improvement activities.
The primary responsibility of the perioperative nurse and the members of the surgical team is the primary responsibility of the perioperative nurse and the members of the surgical team. 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. 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. Errors in surgical counting can result in the inadvertent retention of a surgical article, which is considered an unacceptable error due to the serious negative impact it can have on the health and safety of the patient.
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. 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”.