Outpatient Surgery Magazine - Subscribers

Secrets to Speedier Room Turnover - November 2013 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 22 of 156

OSE_1311_part1_Layout 1 11/6/13 8:56 AM Page 23 SAFETY Policy into practice To improve your counting practices, start with a sound policy. You can't go wrong using AORN standards as a foundation. They recommend 2 people — the circulating nurse and a surgical tech — conduct a manual count concurrently, visibly and audibly. Because the aim is to reduce variability and create a consistent process, carry out the steps in a prescribed order. A policy should outline which items you need to count — anything that could potentially be left in the body — and the manner and sequence in which you're to count them (such as, start at the field and move outward, sponges first). The policy may even include specialty-specific counting guidelines, as different procedures may need, or not need, different preventive precautions. Is it necessary to count all instruments after an eye case, for example? Or, because a bladder cystoscopy is performed through the urethra, the likelihood of leaving unnoticed items behind seems pretty slim. You want your policy to be thorough and routine, but not onerous. It should provide safety, but not make it such a burden that your staff eventually stops following it when you're not watching. We found that counting bags are a valuable, low-tech way to keep track of sponges that have been discarded from the sterile field. As seen in the photo above, a single-use, see-through plastic, pocketed bag hangs from an IV pole, allowing a visual running tally of discarded sponges. These bags can add a lot of efficiency to counts if they're filled throughout surgery, and staff don't wait until the end of a procedure to bag the sponges. Your counting policy shouldn't neglect instructions on what to do in the event that a closing count comes up short. If the item isn't found on the field, or on the floor, or in the trash, an all-points-bulletin usually N O V E M B E R 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E 2 3

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