counts question

[trixie_s_CNOR]

I am wondering what other facilities do for counts. Currently, sponge/sharp count is recorded on a pad of paper in the room, but administration is "encouraging" counts on both a white board AND the pad of paper. I am concerned that having 2 places to record counts could lead to errors. In a busy case it might be difficult to remember to record added needles/sponges in 2 places. Does anyone have any information about the safety of recording counts in 2 separate places? Thanks for any assistance with this!

[linda2097]

I agree double documenting is a bad idea. It is hard enough to write down a count addition on one place when you are trying to do 5 tasks at a time.

If you want to be REALLY safe with your count documentation, every time you add a needle, write down the quanity, type of suture, and time of day. For example.....

QTY...... TYPE........................ TIME...... TOTAL

2...........2-0 vicryl CT-1.......... 12:22....... 2

4.......... 3-0 vicryl SH............. 12:42....... 6

2.......... 4-0 monocryl ps1..... 13:10....... 8

[Scrubby]

At my work we don't consider the white board count to be a legal document. The count sheet that goes in the patients medical records is the legal document. The white board is really only for the benefit of the scrub nurse so they don't have to keep asking the scout nurse what the count is.

Linda-. Our unwritten policy is for the scrub nurse to keep all their suture packets on the field so they have a record of exactly what they have. If there is a question on how many sutures there are then the scrub counts all their packets.

[linda2097]

At our facility, we throw away the count sheet at the end of the case.

Linda-. Our unwritten policy is for the scrub nurse to keep all their suture packets on the field so they have a record of exactly what they have. If there is a question on how many sutures there are then the scrub counts all their packets.

Scrubby, AORN disapproves of counting suture packets....

"Empty suture packages should not be used as confirmation of a correct count. Saving the suture packages may serve as a reminder that a particular suture was used, but this is not an appropriate way to confirm a needle count. Needles and sharps should be counted audibly and concurrently by the scrub person and circulating nurse at the beginning of the procedure, as items are added to the field, and at the end of the procedure per the facility's policy. (11) If there is a discrepancy in the count, the facility policy should be followed and documented."

http://findarticles.com/p/articles/mi_m0FSL/is_4_81/ai_n13648920/pg_4/?tag=content;col1

[cornpoohRN]

We use a white board for the initial count and add as needed throughout the case. Our intra op record just has 4 places to document where the two people who did the initial count (names of the circulator and the scrub nurse/tech) then places for initials for the closing and final counts.

We just changed our policy for ANY lap case that turns open (unscheduled) must have a mandatory xray before the pt. leaves they room.

I carry a couple extra colors of dry erase markers in my pocket so that anything I add to the initial count (which I do in black) I can easily distinguish between it and what I have added to the field (I am a visual person and it helps).

[Scrubby]

At our facility, we throw away the count sheet at the end of the case.

Scrubby, AORN disapproves of counting suture packets....

"Empty suture packages should not be used as confirmation of a correct count. Saving the suture packages may serve as a reminder that a particular suture was used, but this is not an appropriate way to confirm a needle count. Needles and sharps should be counted audibly and concurrently by the scrub person and circulating nurse at the beginning of the procedure, as items are added to the field, and at the end of the procedure per the facility's policy. (11) If there is a discrepancy in the count, the facility policy should be followed and documented."

http://findarticles.com/p/articles/mi_m0FSL/is_4_81/ai_n13648920/pg_4/?tag=content;col1

Thanks but we don't' follow AORN standards, we have our own Australian standards (ACORN). Very similar standards but as far as I'm aware ACORN doesn't disapprove of this practice. And it is an unwritten policy anyway. Personally as a scrub nurse I like this method because quite often the count is wrong if you have a scout who is rushed off their feet, or incompetent (plenty of those at my work).

I feel that writing every type of suture given to the scrub and what time given would not work in my particular area because we're not given enough time.

[linda2097]

Thanks but we don't' follow AORN standards, we have our own Australian standards (ACORN).

Ooops. Oh well, my advice still applies to most readers here.

I feel that writing every type of suture given to the scrub and what time given would not work in my particular area because we're not given enough time.

You don't have to write everything at the same time. Just write the number of sutures added, and then when you get a chance, add more details. When counts are incorrect, the biggest mystery is whether or not you wrote down a particular suture. My method makes it a lot easier to figure out.