surgical count

We only count instruments for open cavities. The exception is kids under 25 pounds. We generally don't count on laparoscopic cases unless there's a high probability of opening.

We only count instruments on cases where we open a cavity (chest, abdomen, etc). If it's a laparoscopic case, we count instruments before in case it turns into an open case but not after if it stays laparoscopic.

This or we do an post-op xray.

AORN guidelines state you count if you open a cavity (or potentially could...i.e. laparoscopic cases). There is no distinction for weight limits (peds should be counted)...however you ALWAYS count sponges and sharps (except maybe for a cataract)...however you don't just count because you could leave an item inside a patient....it is also for the protection of those on the field (missing a needle? Don't want to get stuck? How would you know? Not all scrubs are that conscientious) and protection for those cleaning up afterward.

MereSanity BSN, RN, CNOR

I have always counted total instruments prior to a case. An open cavity, any area where the instruments can be placed inside the body, abdomen, chest, but also hip and shoulders. Too many lawsuits where something including instruments were found near a shoulder or hip. Also all laps the instruments are counted. I have never based any count on weight. So why is it this place does not count? I do not understand their rational at all.

Can you tell me, do you count prior to total hip or shoulders? And by count I mean a total not individual

OP, are you working in the States? Can you give a little more info about not counting instruments, i.e., is this for every case, for particular cases; does EVERY tech refuse to count instruments, or just one?

Every case. They will not count instruments. Stating they do not do that here. This is in the us

You are the nurse and IN CHARGE...that tech should be fired! Instrument counts have to do with how many "layers" you go through...hips, shoulders, knees...you do not count instruments but definitely everything else (sharps and sponges). Don't you have an AORN recommended standards book? That is the bible of the OR...and it sounds like you could be liable for not following it. If the tech refuses to count tell her she isn't scrubbing that case...and just because they have always done it that way doesn't make it right....remember YOU have a license to lose...NOT her!