Swab and instrument count practice: ways to enhance patient safety

This article presents the results of an audit of swab and instrument count practices in the operating department of a large hospital NHS Trust in South East England. A literature review of the subject is presented followed by the methodology used including questionnaires and observation of practice. Findings are discussed in terms of compliance with the department's swab and instrument count policy and observed practice mapped against the recommendations for best practice in the literature. The findings show that audit of practice is still treated with suspicion by many and that a number of practices of scrub and circulating personnel in operating theatres need to be improved. Recommendations are made related to improving staff development in the department and introducing clinical supervision as one way to provide support for colleagues to reflect on their practice and change to more evidence-based practices in the operating department.