Surgical Count Implementations in the Operating Rooms: An Example from Turkey

Abstract

Aim: Although retained foreign bodies are a rare and preventable problem, it is one of the medical errors in surgery can have heavy medico-legal consequences. Retained sponges can cause significant morbidity, prolonged hospital stay, postoperative complications, pain and disabilities. Also the costs associated with treatment of retained surgical items can be considerable. The study was undertaken to determine the current implementations related to instruments and sponges counts in the operating rooms in Turkey. Method: This descriptive study was carried out with 261 operating room nurses. The data collection tool was a questionnaire which was designed on the Google Drive application using the internet. Thereafter its internet link was distributed throughout Turkey using nursing, surgical nursing and operating room nursing social media websites; the answers were gathered in the same way. Results: Ninety-five percent of participants stated that instruments and sponges were usually counted by the scrub nurses (88.5%). Sponges (97.7%), pads (95.4%), tampons (89.2%), surgical instruments (88.1%) and needles (70.4%) were the items which were usually counted. According to 81.6% of the nurses, a written count protocol exists for their hospitals, however, they noted there was a significant difference in implementation among the various institutions (p=0.026). While 49.8% of participants stated that the count before surgery was done by nurses, 23.7% reported that the count was performed by operating room employees. Furthermore, 81.2% of the nurses noted that if the scrub nurses were replaced during surgery, the surgical count would be repeated. Nurses stated that last count was usually done just before applying skin sutures (72.7%), and if there were a problem with the count, radiological imaging would be done (73.5%) and the count irregularity would be signed by staff (31.0%). Conclusion: Our results demonstrated that because surgical counts were generally done by the scrub nurses, changing of scrub nurse have high risk for surgical count error. In addition, although most of the hospitals have a count protocol, a serious issue concerns the use of unprofessional hospital employees who carry out this task, thus jeopardizing patient safety to be operating room employess join the count are other problems related to surgical count. There is not any comprehensive research related to surgical instrument and material count in Turkey. The current study enables us to obtain information concerning surgical count protocol in the operating rooms in Turkey.