The patient, case, individual and environmental factors that impact on the surgical count process: An integrative review

Abstract

Problem identification The surgical count is an integral component of the perioperative nurse's role designed to reduce the risk of unintentional retained items (URIs) during surgery. Current literature provides statistical data that URIs continue to occur which has exposed a lack of adherence to the surgical count process as a possible contributing factor. This review was undertaken to identify what is currently known about perioperative nurses' practices in relation to the surgical count and the perceived barriers and enablers when trying to follow best practice as outlined in ACORN's Standards for Perioperative Nursing in Australia. Literature search The objective of the search was to identify empirical data relating to nurses' knowledge and practices in relation to the surgical count. We identified 215 research papers in the literature search using search terms consisting of instrument counts, culture and patient safety. Data evaluation synthesis Studies from 2003 to 2018 were categorised methodologically as qualitative, quantitative and mixed methodologies. All papers were reviewed by the authors separately to extract key information around design, sample size, aim, key findings and limitations. Studies were critically appraised using the mixed method appraisal tool (MMAT) for mixed method studies and the QualSyst tool for quantitative and qualitative studies. The literature search identified a total of 215 studies, 109 of which were identified for further review using the 'preferred reporting items for systematic reviews and meta-analysis' (PRISMA) flow chart. Six exclusion criteria were applied to exclude a further 52 articles from the final review, which resulted in ten articles being included in the final sample.

Judicialization of nursing malpractice in perioperative care, and delivery and birth assistance

“…In a study conducted to analyze the surgical counting process, we identified that the count of the compresses was always performed before the end of the surgery, and the control was performed by counting the compresses when opened and when discarded (29) . Another type of conference cited was that in which the room worker opened the packages and requested that another professional perform the conference of the open compresses on the surgical table, then making notes on the blackboard (29) . As more compresses were requested, these were noted on the board, as well as the removal of each, and, at the end of the surgery, the conference was performed with the compresses used (29) .…”

“…Another type of conference cited was that in which the room worker opened the packages and requested that another professional perform the conference of the open compresses on the surgical table, then making notes on the blackboard (29) . As more compresses were requested, these were noted on the board, as well as the removal of each, and, at the end of the surgery, the conference was performed with the compresses used (29) . This practice is considered simple, but when performed in a systematized way, it avoids the retention of any foreign body inside the patient.…”