Preop Counting

Question 1

Sponges

Never assume a manufacturer’s prepackaged item is correctly counted

Answer 1

incorrect number of sponges should be removed from the sterile field, bagged, labeled as incorrect and the number of sponges in the bag

Question 2

Sharps

Answer 2

. Scalpel blades
. Suture needles
. Hypodermic needles
. Bovie tips
. Saw blades/drill bits

Question 3

Broken or separated instruments

Answer 3

. CST and the circulator should account for instruments that break or parts become separated.
. It is recommended the CST inform the surgeon and circulator, collect all the broken or separated portions, verify all pieces are accounted for.

Question 4

Documentation

Answer 4

. The initial count should be recorded on the count sheet by the circulator as reference to ensure an instrument is not retained.
. Intraoperative additions of an instrument, or instruments, should be recorded on the count sheet and added to the initial count.
. Sponge, sharp and instrument counts should be documented in the patient’s intraoperative record and included in the patient’s chart.

Question 5

documented counts should include the following information

Answer 5

1. The documented counts should include the following information:
   A. Types of counts
   B. Number of each item counted
   C. Names and titles of surgical team members who performed the counts
   D. Results of the counts, ex. correct or incorrect
   E. Measures taken to resolve incorrect counts
   F. Explanation for counts not performed
2. The CST should sign the intraoperative record next to where the counts are recorded; credentials should be included.
3. The surgeon should be given a verbal confirmation of correct count results.

Question 6

INCOMPLETE COUNTS

Answer 6

. The proper steps should be completed to resolve a wrong count and prevent the retention of a foreign object
- inform the surgeon of the incorrect count
- visual search of the sterile field and nonsterile field should be initiated
- The surgeon may perform an exploration of the abdomen or cavity
- intraoperative X-ray should be ordered and taken, before the surgical wound is closed
- All steps taken to find the missing item should be documented in the patient’s record, including communications among the surgical team and with other facility staff members