WEDNESDAY, March 5 (HealthDay News) -- The importance of maintaining accurate surgical counts, with special focus on complicated scenarios such as trauma surgery, is the subject of two papers in the February AORN Journal.
Darlene B. Murdock, R.N., of the Memorial Hermann Hospital in Houston, a level I trauma center, writes that trauma patients often arrive in the operating room with only a few minutes for the perioperative team to conduct initial surgical counts. Steps to prevent retained objects include routinely taking intraoperative X-rays for high-risk procedures, maintaining continuity by having the same team start and finish high-risk cases if possible, and using sponges containing radio-frequency identification tags, an emerging technology that alerts staff to the presence of retained sponges when a scanner is passed over the patient.
Other patients at higher risk of retained items include those who are obese, those having lengthy procedures, and those whose procedures become altered, such as a laparoscopic procedure converted to an open procedure, write Sarah Jackson, R.N., of the Harry S. Truman Medical Center and Sharon Brady, R.N., of the University of Missouri Hospital, both in Columbia, Mo. In addition, distractions at critical times during surgery can spur count errors, such as staff changes and the addition of items to the field. Having surgeons on board with a facility's count policy will help ensure that the entire team cooperates during the counting process.
"It is the direct responsibility of all members of the surgical team to ensure the patient's safety. Team members must use their knowledge of the problems with the count process to be diligent and deliberate during the counting phases of the surgical procedure so no patient has to suffer from a retained item," they conclude.
Abstract - Murdock
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Abstract - Jackson, Brady
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