Clinical Issues-March 2022.

Area of Science:

• Nursing
• Surgical Safety
• Radiology

Background:

• The nursing scope of practice is defined by state nurse practice acts (NPAs) and state boards of nursing.
• Unlicensed perioperative personnel have specific roles and limitations regarding task delegation and scope of practice.
• Accurate surgical item counts are critical for patient safety to prevent retained surgical items (RSIs).

Purpose of the Study:

• To delineate the nursing scope of practice and the role of unlicensed allied health care providers.
• To establish a clear definition of a cavity for surgical counting procedures.
• To explore methods for identifying retained suture needles on radiographic images to address count discrepancies.

Main Methods:

• Review of state nurse practice acts and relevant literature.
• Analysis of job descriptions and delegation protocols for unlicensed perioperative personnel.
• Development of a definition for 'cavity' in the context of surgical counting.
• Evaluation of radiographic imaging techniques for identifying retained suture needles based on size and length.

Main Results:

• State NPAs and boards of nursing provide the framework for nursing practice and decision-making.
• Clear job descriptions and task delegation guidelines are essential for managing unlicensed personnel.
• A standardized definition of 'cavity' aids in accurate surgical item counts.
• Radiographic imaging can effectively identify retained suture needles, assisting in resolving count discrepancies.

Conclusions:

• Understanding and adhering to the nursing scope of practice is crucial for safe patient care.
• Proper management of unlicensed personnel and clear definitions for surgical procedures enhance safety.
• Radiographic identification of retained suture needles improves the resolution of surgical count discrepancies and patient safety.