Surgical count process for prevention of retained surgical items: an integrative review

Freitas, Patrícia Scotini; Silveira, Renata Cristina de Campos Pereira; Clark, RN Alexander Michael; Galvão, Cristina María

doi:10.1111/jocn.13216

Cited by 28 publications

(30 citation statements)

References 32 publications

(186 reference statements)

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“…The use of scanning technologies (sponges with bar codes and sponges with radio frequency identification labels) is encouraged, being adopted as a complement for manual counting and seen as relevant investment to prevent the problem (18)(19)(20) . Regarding the counting of surgical instruments, 23 nurses (44.2%) reported that the procedure was not carried out in the surgical center where they worked.…”

Section: Variablesmentioning

confidence: 99%

Processo de contagem cirúrgica: evidências para a segurança do paciente

Freitas

Mendes

Galvão

2016

Rev. Gaúcha Enferm.

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Objective: To analyze the surgical count process according to reports of nurses working in surgical centers of a city in the state of São Paulo. Methods:Cross-sectional study with a sample of 55 nurses. Data collection occurred from August to December 2013, with application of an instrument submitted to face and content validation, composed of data on variables regarding characteristics of nurses, hospital, and surgical count process.Results: Fifty-two (94.5%) nurses reported that the surgical count process was carried out in their workplaces. A statistically significant association was found between the surgical count process and the type of institution (P=0.046), and between the presence of a surgical technologist and the processes for counting surgical instruments (P<0.001) and sponges (P=0.016). Conclusion:The results found contributed to understand how, by whom, and when the surgical count process was carried out in the studied hospital. Métodos: Estudo transversal, com amostra de 55 enfermeiros. A coleta de dados ocorreu de agosto a dezembro de 2013, com aplicação de instrumento submetido à validade de face e conteúdo, composto de dados sobre variáveis relativas à caracterização do enfermeiro, hospital e processo de contagem cirúrgica.Resultados: 52 (94,5%) enfermeiros responderam que o processo de contagem cirúrgica era realizado no seu local de trabalho. Houve associação estatisticamente significante do processo de contagem cirúrgica com o tipo de instituição (P=0,046), da presença do instrumentador com os processos de contagem de instrumentos cirúrgicos (P<0,001) e de compressas (P=0,016). Conclusão:Os resultados evidenciados fornecem subsídios para a compreensão de como, por quem e quando o processo de contagem cirúrgica era realizado no contexto hospitalar.Palavras-chave: Enfermagem perioperatória. Segurança do paciente. Pesquisa em enfermagem. RESUMENObjetivo: Analizar el procedimiento de recuento quirúrgico según el relato de los enfermeros que trabajan en unidades de centros quirúrgicos de un municipio del estado de São Paulo.Métodos: Estudio transversal con una muestra de 55 enfermeros. La recolección de datos ocurrió entre agosto y diciembre de 2013 con la aplicación de instrumento sometido a la validación de cara y contenido, compuesto de los datos sobre las variables relacionadas a la caracterización del enfermero, hospital y procedimiento de recuento quirúrgico.Resultados: 52 (94,5%) enfermeros respondieron que el procedimiento de recuento quirúrgico se llevó a cabo en el lugar de trabajo. Se observó una asociación estadísticamente significativa del procedimiento de recuento quirúrgico con el tipo de institución (P=0,046); la presencia de matorral con los procedimientos de recuento de los instrumentos quirúrgicos (P <0,001) y de compresas (P=0,016). Conclusión:Los resultados encontrados ayudan en la comprensión acerca de cómo, por quién y cuándo el procedimiento de recuento quirúrgico se llevó a cabo en el ámbito hospitalario.Palabras clave: Enfermería perioperatoria. Seguridad del pac...

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Section: Variablesmentioning

confidence: 99%

Processo de contagem cirúrgica: evidências para a segurança do paciente

Freitas

Mendes

Galvão

2016

Rev. Gaúcha Enferm.

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“…It is suggested that a white board should be provided in operation room, a nurse should write down each instrument and material on the board or ensure that somebody do it [12]. As counting process depends on the human factor, it has high probability of error.…”

Section: Surgical Count Implementations In the Operatingmentioning

confidence: 99%

“…A Questionnaire formed by researchers using relevant sources [3,6,9,12] and consisting of 23 questions was used as data collecting instrument. The questionnaire was formed online, using Google Drive.…”

Section: Data Collection and Analysismentioning

confidence: 99%

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Surgical Count Implementations in the Operating Rooms: An Example from Turkey

Candaş¹,

Bulut²,

Çilingir³

et al. 2017

Surgery

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Journal of Surgery IntroductionOperating rooms, due to their complex structure and crowdedness and cases that can change suddenly, are the surgical units where unwanted incidents can occur frequently [1]. Forgetting a sponges and instruments in the surgical field is one of these unwanted incidents that may occur in an operating room [2,3]. Forgetting a sponges and instruments inside patient's body, is not a medical error but a preventable incident [4,5]. Studies demonstrate that the rate of forgetting a surgical sponges and instruments inside a patient's body, ranges from 1/1,500 to 1/19,000 [5,6]. American Surgical Association stated that retained surgical instruments case is occured at least once a year in each hospital and significant procedures are applied for 8,000 and 18,000 of these [7,8]. Retained surgical instruments cases mostly happens in the surgical field of abdomen (46-55%), but also pelvis, chest, and vagina can be included in this category [5,9]. The frequency of retained foreign objects cases ranges from 1/1,000 to 1/1,500 in abdominal and pelvic surgery. Although it is not frequent, retained foreign objects cases is found in orthopedics, urology and neurologic operations [5].During the course of surgery, everthing which can cause a reaction in patient, can be identified as foreign object. Within this scope, the most frequent retained surgical instruments are, sponge that ranks first and followed by surgical instruments, ecarteur, needle and compress [3,9,10]. Furthermore, broken surgical instruments, rubber tubes, and AbstractAim: Although retained foreign bodies are a rare and preventable problem, it is one of the medical errors in surgery can have heavy medico-legal consequences. Retained sponges can cause significant morbidity, prolonged hospital stay, postoperative complications, pain and disabilities. Also the costs associated with treatment of retained surgical items can be considerable. The study was undertaken to determine the current implementations related to instruments and sponges counts in the operating rooms in Turkey.Method: This descriptive study was carried out with 261 operating room nurses. The data collection tool was a questionnaire which was designed on the Google Drive application using the internet. Thereafter its internet link was distributed throughout Turkey using nursing, surgical nursing and operating room nursing social media websites; the answers were gathered in the same way.Results: Ninety-five percent of participants stated that instruments and sponges were usually counted by the scrub nurses (88.5%). Sponges (97.7%), pads (95.4%), tampons (89.2%), surgical instruments (88.1%) and needles (70.4%) were the items which were usually counted. According to 81.6% of the nurses, a written count protocol exists for their hospitals, however, they noted there was a significant difference in implementation among the various institutions (p=0.026). While 49.8% of participants stated that the count before surgery was done by nurses, 23.7% reported that the count was perfor...

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“…In two studies, 2% of 54 and 1.4% of 71 patients with RSIs died. [18] The average medico-legal expense of retained surgical items ranges from $37,000 to $2,350,000 per incidence. [18] …”

Section: Retained Surgical Itemsmentioning

confidence: 99%

Charting the course for American Nurses Credentialing Center–Approved perioperative nurse-sensitive indicators

Shepherd¹,

Hawthorne²

2017

JNEP

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The current health care environment, with increasing public awareness of and attention to patient safety, mandates the delivery of exceptional quality care. To meet the health care requisites of the perioperative patient population, clinical nurses have identified the need for nurse-sensitive clinical indicators for this setting. We describe the strategies used to identify, obtain American Nurses Credentialing Center approval for, and integrate nurse-sensitive indicators into the perioperative setting to advance a Magnet culture. Prior to this, nurse-sensitive indicators for the perioperative setting that enabled nurses to monitor and improve patient care outcomes, in accordance with the standards of a Magnet-recognized hospital, had not been formally established. A review of the literature yielded a list of potential metrics, which included normothermia, patient falls with harm, and retained surgical items. Methodology and data collection processes for these metrics were established, facilitating quarterly Nursing Dashboards and collaboration among nurses to improve patient outcomes. This groundbreaking initiative enables nurses to routinely evaluate whether the structures and processes of care effectively yield quality outcomes. This foundational work has broader implications for nursing practice, because these quality metrics can easily be translated into perioperative settings in other health care organizations.

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Surgical count process for prevention of retained surgical items: an integrative review

Cited by 28 publications

References 32 publications

Processo de contagem cirúrgica: evidências para a segurança do paciente

Processo de contagem cirúrgica: evidências para a segurança do paciente

Surgical Count Implementations in the Operating Rooms: An Example from Turkey

Charting the course for American Nurses Credentialing Center–Approved perioperative nurse-sensitive indicators

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