A review of existing count practice in the operating suite to achieve best practice and safe patient care.

Abstract

Abstract: Patients are exposed to significant perioperative risk in relation to retained instruments or products. A responsibility of the perioperative team is to ensure that the surgical count is performed in a way that maintains patient safety. The aim of the project was to evaluate existing count processes, identify areas of high risk and implement practice changes, in consultation with the perioperative team. An inconsistent count process was observed between team members and three areas of high risk identified. Explicit 'non-negotiable' guidelines were created regarding accountable items, a double-checking process introduced for verifying sutures and a formal process for 'bagged off' items established, particularly during changeover of teams. An observational audit tool was created to determine the compliance of staff to these changes. The audit results in November 2012 demonstrated the importance of standardised count practices and the need to develop explicit count guidelines to achieve our common goal of safe patient care. The results of a questionnaire conducted in May 2013 showed 100% of the staff felt the implementation of the new count process created standardised count practices in the Epworth Eastern operating theatre, reducing the potential risk for the perioperative patient.