count sheet

I have noticed that a few of my fellow nurses will sign the count sheet before the final count is completed. They will sign it after the initial count. This doesn't seem right to me, as I always thought that you shouldn't pre-sign anything, and that you don't sign the count sheet until the final count is completed!

What will often happen is that a nurse will pre-sign for the count, get called away, and not even be there for the final count, even though they signed for it. When I asked them why, it is usually "no particular reason" or "in case I forget to do it later"

Does anyone have any ideas, comments? Or is it just me?

Ta

Ms HB

[suzanne4, RN]

First of all, welcome to Allnurses.com...........................

If they sign the final count sheet before the count is actually done and something is missing..............guess who can easily get blamed..........

There is absolutely no way that I would ever do that or any of the nurses that I worked with in the US. You are definitely jeopardizing your license ithat way, at least in the US you would, and I don't think that Australia is any different..............

:uhoh21:

[MsHB]

Thanks suzanne4

Thats exactly what I thought. They really are leaving themselves wide open for something to happen. Other then this problem I really couldn't fault their standards and methods, but they will insist on doing it!

[carcha]

some years ago in the or room next door to me a newly qualified nurse was advised by a senior nurse that she should sign the count sheet even though the junior nurse was simply there on tea relief and had not performed any counts.Not knowing she did,and when tea relief was over went back to her own room. Guess what, two weeks later the patient returned with a sponge in. My message is, that though this girl did no counts at all her signature was on this sheet. She then had to sign a statement explaining why she had signed ect ect. It amazes me that anyone should put themselves in a potantially litigous situation when they havent even done a count. Stupid, stupid stupid.

[mcmike55]

I agree with you all. If you sign that count sheet that it was correct, you better darn well have counted them, yourself!!!!

However, in a slightly different tract. Is everyone in the entire world doing an instrument count???

Count sharpes and sponges of course, but is everyone doing instruments?

There is more than one study out there that has shown instrument counts do not guarantee an clamp won't be left behind.

Understand, I am not arguing either way. Just asking

[shodobe]

It is interesting that at one hospital I work at, part-time, they don't seem as concerned about an instrument count all the time. At the one I have worked at for 27 years, we count instruments at the times where it is required. No question about it, it is done. Mike

[mcmike55]

No argument, shodobe, I am sure that most (?) OR's are doing counts.

We have gone back and forth on the issue. Currently we (gasp) don't do instrument counts. I hurry to say that we don't do much that would be called bariatric surgery, a common factor in lost instruments. Also our docs and techs are very good about instrument handeling.

I can hear you say it, accidents happen!!! And I totalling agree.

I guess that's why I brought it up, I see both sides.

By the way, shodobe, glad to hear from you. I always enjoy reading your postings, and hearing your thoughts.

I am totally addicted to this website. I can't be away too long!!!!

[MsHB]

No count of instruments? I guess the scrub nurse would be pretty stressed about keeping track of everything? I know I would be.:uhoh21:

[shodobe]

I do have to admit, it seems the hospital which has the counting problem is getting much better. They have begun doing bariatric cases over the past few months and actual counts on the majority of belly cases have gone up ten fold. There are still the times on smaller cases where they don't count. Counting is a must and if it isn't then it should be. I was involved in a return case where a sponge was found over a year later in a patient. My name and another very solid nurses name was on the record. I swear I didn't remember anything but a correct count but there it was a year later, a lap sponge! Lucky for me and my partner, the surgeon was able to explain this unfortunate accident to the patient and they accepted it with no questions asked. I was very lucky in this because of the relationship I have with the surgeon and his special relationship with his patients. I think if it had been with anyone else I might have found myself in a dreadful lawsuit. This is why I feel counting is worth the time and effort and if your facility isn't doing it just to save a little time anice little lawsuit will always open up the eyes. Tell your manager it isn't acceptable to put his/her nurses in the line of fire. Good luck, Mike

[MsHB]

Shodobe, please excuse my ignorance but would you explain what bariatric cases are?

Ta

MsHB:imbar

[suzanne4, RN]

Bariatric surgry procedures are done for patients that are morbidly obese.

Depending on facility and surgeon, most common procedure is a Roux-N-Y, which decreases the size of the stomach and essentially removes a section of small intestine so less food can be absorbed. Procedure is also available laparoscopically in some areas. Major side effects are nausea and vomiting, infection, and electrolyte imbalance. If you actually put bariatric surgery in a search engine you will come up with many hits.

Hope that this helps............. :balloons:

[shodobe]

Thanks suzanne4, I should have explained that procedure. Mike