year.
"If you're counting everything, you shouldn't have retained items,
right? But obviously it's more complicated than that because we have
retained items," says Ms. Wood. "What's so hard about counting from 1
to 10? The way our brains are wired and the distractions we face in a
very complicated environment make counting a lot more difficult than
you think."
Ms. Wood detailed 4 key takeaways from the guideline so that, as
she puts it, "what you put into the patient is what comes out."
• Prevent retained objects as a team. Counting is everyone's job.
All perioperative team members are responsible for the prevention of
retained surgical items. Preventing retained items is more than a
count and more than a check on a checklist. It's about accountability
and everyone's involvement. The OR team should verbally verify the
final count.
• Minimize distractions during the count. Distractions and interrup-
tions reduce human reliability when counting. Test subjects couldn't
accurately count dots on a computer screen when they were distract-
ed. Distractions in the OR abound, from the pressure to count quickly
so the surgeon can close, to the surgeon refusing to stop closing so
you can take the count. Create a no-interruption zone for counting. If
you're interrupted during a count, don't resume counting but rather
start over from zero. Don't start counting during critical phases of the
procedure, including the time out. Take care of patient care needs
before you start the count. Once the patient enters the room, you
have an immediate distraction and the patient needs 100% of your
attention, so it's better to do the initial count before the patient comes
into the room. Remember: If the baseline count's not accurate, none
of the others will be accurate.
• Use consistent counting methods. You don't want the count to
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