FUNCTION:  Operative and Other Invasive Procedures

 

TITLE:  Counts, Sponge, Needle, Instrument

_________________________________________________________________

 

PURPOSE:

 

Materials counts are necessary to provide a standard of quality of care for

the surgical patient and to provide a method of accounting for items placed on

the sterile field for use on a surgical procedure.

 

POLICY:

 

1.   All counts are completed audibly by the Scrub RN/Technician and RN

     Circulator while each item is being viewed.

 

2.   Raytec, lap sponge, neuro patty, kittner, blade and needle counts are

     done prior to start of procedure; soft goods should be radiopaque.

 

3.   Counts of all of the above are done at beginning of closure of wound and

     again just prior to skin closure.

 

4.   Instruments are counted on all procedures when a major body cavity is

     entered and where the depth of the procedure could result in the loss of

     an instrument.       

 

5.   Instrument counts are done using count sheets found in sterile instrument

     trays.

 

6.   Instrument counts are done prior to start of procedure and immediately

     prior to closure of the wound.

 

7.   All counts are documented on the OR Record with the following

     information:

     a.   type and number of counts (e.g., sponge count #1 - correct);

     b.   name and title of OR personnel completing the count;

     c.   results of each count;

     d.   action taken if count is incorrect (e.g., Surgeon informed, X-ray

          taken);

     e.   signatures of OR personnel completing the count.

 

8.   In the event that a count is incorrect, the RN Circulator notifies the

     Surgeon and a search is initiated.  In the event an item is not located,

     an X-ray must be taken and read by a Radiologist prior to the patient

     being transported from the OR Suite.

 

9.   With an incorrect count, the RN Circulator will complete an "Incident

     Form" and document "Surgeon informed" on the OR record.

 

10.  All items involved in materials and instrument counts should remain in

     the operating room until conclusion of the operative procedure.