Count Policy for 360 Spines

[nurseboudin]

Does anyone have an effective count policy for 360 spinal cases? Our staff is extremely frustrated with counting trays upon trays of instruments, implants, individual retractor pieces, etc... These counts take forever, but are deemed absolutely necessary. Has anyone implemented alternate setups or found a way that makes this process more effecient without compromising patient safety?

[PetiteOpRN]

My facility does not count instruments for these cases (at least it is not our policy -- I recently transferred to neuro, and have yet to do one, so I don't know how it would go over if I insisted on counting), just sponges and sharps.

There is a monumental number of instruments and implants, so I can see why they would try to avoid counting, but an open belly is an open belly.

I am curious to see how other facilities handle this, because our policy just doesn't seem safe.

[nurseboudin]

Yeah, I agree in that it doesn't seem safe. Nor does keeping a patient under anesthesia for prolonged periods of time: count times have exceeded 40 minutes in some cases. That's just painful. We are looking to revamp our count policies for these cases. Do you know if anyone in your organization has developed a creative way to make the process more efficient?

[PetiteOpRN]

For hearts, we have a pre-printed sheet that has all of the instruments according to tray, so it's pretty simple to go down the list. There's also the "cover everything I don't really need with a towel" method, which some nurses allow.

That might help make the counts go a little faster.

[Argo]

policy states to count, aorn standards say to count.... if something happens and you get sued you wont have a leg to stand on. Counts might stink but is part of the job we do. Good count sheets do make a big difference though.