Abstract
Objective To systematically measure and describe perioperative nurses’ surgical count practices using the Surgical Count Observational Tool, to measure conformity with standardised processes and identify barriers and enablers influencing nurses’ practices. Sample and setting A large public tertiary hospital in Western Australia. Methods The Surgical Count Observational Tool (SCOT) was developed using the Content Validity Index over two Delphi panel rounds and then pilot tested. Individual observations were analysed according to 14 criteria based on the 2016 Australian College of Perioperative Nurses (ACORN) standard ‘Management of accountable items used during surgery and procedures’1. Count processes were observed over two consecutive weeks across six specialist perioperative teams including nurses, surgeons, anaesthetists and technicians to measure compliance with the ACORN standard. The SCOT and a field diary were then used in an observational study of 83 nursing staff, including 54 circulating nurses and 29 instrument nurses, over a period of 57 hours. Interrater reliability was calculated using Cohen’s kappa. Descriptive statistics were used to analyse observational data. Results Of the 1268 count practices observed, 759 were compliant with the ACORN standard, representing a 60 per cent compliance rate. Conclusion Consistency and compliance rates were lower than expected. Patient, case, environmental factors and expectations of surgeons and co-workers were observed to act as barriers to best practice in perioperative nurses undertaking a surgical count, while nurse’s knowledge was observed to act as an enabler.
Highlights
In 2006, the Australian Commission on Safety and Quality in Health Care (ACSQHC) was established as part of an Australian initiative to improve safety and quality in health care
Individual observations were analysed according to 14 criteria based on the 2016 Australian College of Perioperative Nurses (ACORN) standard ‘Management of accountable items used during surgery and procedures’[1]
Case, environmental factors and expectations of surgeons and co-workers were observed to act as barriers to best practice in perioperative nurses undertaking a surgical count, while nurse’s knowledge was observed to act as an enabler
Summary
To systematically measure and describe perioperative nurses’ surgical count practices using the Surgical Count Observational Tool, to measure conformity with standardised processes and identify barriers and enablers influencing nurses’ practices.
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