The Surgical Count in Perioperative Nursing - Research Paper Example

Download file to see previous pages This may sound strange but evidence of research and studies proved that incidence of retained sponges and instruments (RSI) happen. This paper presents the observed conformity of evidence-based practice on surgical counts procedure with respect to applied nursing research, taking into consideration the observations and experiences I earned during my actual clinical exposure in a healthcare facility’s operating room (OR) setting where surgical procedure is done. It aims to identify any observed flaws in the procedure base on my personal observation and to determine the common causes of discrepancies in surgical counts in spite of the strict adherence to a standardized guideline adaptable in international surgical settings. To begin with, surgical counts, according to Spry (2005, p. 168), is the “counting of sponges, sharps such as blades and needles, and instruments that are opened and delivered to the field for use during surgery.” The International Federation of Perioperative Nurses (IFPN n.d.) provided the basis for the surgical count practice in order to promote safe, quality perioperative patient care internationally, that is intended to standardize sponge, sharp and instrument counts and includes basic principles as guidelines adaptable in surgical settings internationally. The certified surgical technologist and the circulator (circulating nurse) are responsible in the proper performance of surgical count (Association of Surgical Technologists 2006), but according to Belton and Berter (2004), either a surgical technician or a registered nurse can fill the scrub nurse role in performing the surgical count after surgical hand scrub and aseptically donned a surgical gown and gloves. The surgical count is done to ensure that all items used during the surgical procedure are removed and can be accounted for completion of the procedure (Hamlin, Richardson-Tench, & Davies 2009, p. 88). All surgical items delivered to the sterile field prior to the incision and during the actual surgery are reconciled for completeness to the inventoried items after the end of the surgery (Spry 2005, p. 168). Moreover, the surgical count plays a vital role in enabling the perioperative practitioner and surgical team to enhance the patient’s safety (Rothrock 2002). Rothrock emphasized that surgical items used by the surgical team in performing invasive procedures are foreign bodies to the patient and must be accounted for at all times to prevent retention and injury to the patient. The International Federation of Perioperative Nurses (2009) or IFPN promulgated the general guidelines in surgical count covering surgical count standards as to general criteria, sponge count, sharp count, instrument count, documentation, and count discrepancies. This guideline established by the IFPN (n.d.) was conformed by the Australian College of Operating Room Nurses (ACORN), Association for Perioperative Registered Nurses (AORN), National Association of Theatre Nurses (NATN), Operating Room Nurses Association of Canada (ORNAC), and South African Theatre Nurse (SATS). In spite of the crucial adherence to standardized surgical count procedure, there were evidences showing that discrepancies exist. According to Greenberg, Regenbogen, Lipsitz, Diaz-Flores, and Gawande (2008), “one in 8 surgical cases involves a surgical discrepancy in the count; the majority of which were unaccounted-for sponges and instruments, representing potential retained sponges and instruments.” In the report of amednews staff Kevin B. O’Reilly (September 2008), he stated that “While cases of retained foreign objects are rare, discrepancies in counts happen in 13% of surgeries, according to an August Annals of Surgery study.” O’Reilly (2008), as he cited the Annals of Surgery ...Download file to see next pagesRead More