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Incorrect Surgical Counts: A Potential for Retained Surgical Items
1New York Presbyterian Hospital, New York, New York patricia.nelsonrn@gmail.com.
Journal of Doctoral Nursing Practice
|December 29, 2021
Summary
Implementing the Association of periOperative Registered Nurses (AORN) guidelines significantly reduced surgical count discrepancies by 71.43% and prevented retained surgical items (RSIs). Nurse compliance with standardized surgical counting processes also improved.
Area of Science:
- Nursing Quality Improvement
- Patient Safety in Surgery
- Perioperative Care Standards
Background:
- High rates of surgical count discrepancies (408) and retained surgical items (RSIs) (13) were reported in 2015-2016.
- A lack of consistent, standardized surgical counting processes among nursing staff was identified.
Purpose of the Study:
- To decrease surgical count discrepancies by 25%.
- To prevent retained surgical items (RSIs).
- To enhance perioperative nursing team compliance with surgical count procedures.
Main Methods:
- An evidence-based quality improvement project involving 455 procedures and 118 nurses.
- Utilized the Plan-Do-Study-Act (PDSA) methodology over eight weeks in 2018.
- Implemented the Association of periOperative Registered Nurses (AORN) practice guidelines for RSI prevention.
Main Results:
- Reduced incorrect surgical counts by 71.43%.
- Achieved zero incidences of retained surgical items (RSIs).
- Significantly improved nurse compliance with surgical count practices (p = .046).
Conclusions:
- Adherence to AORN guidelines for perioperative surgical counting enhanced the surgical count process.
- A systemic approach to performance improvement is crucial for preventing RSIs.
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