nate retained
objects. Items are
left behind most fre-
quently in the
abdomen and pelvic
areas, from where
they can migrate to
the intestine, blad-
der, thorax and
stomach. The conse-
quences can be dev-
astating. Retained surgical items can result in reoperation to remove
the missing object, post-op infection and, in rare cases, even death.
Retained items generally involve a deviation from routine counting
practice caused by distractions, excess noise, time pressures, multi-
tasking, fear of speaking up or poor teamwork. Your surgical team
members must work together to develop a standardized, transparent,
verifiable and reliable counting protocol — and then hold each other
accountable to following it. Active participation in the process
improves communication and teamwork. You must first define the
roles and responsibilities each team member has in the counting
process.
• Circulating nurses. They must ensure there are no counted items
remaining in the OR from the previous case as they set up the room.
They then perform the initial count, with help from a scrub tech, by
noting the number of soft goods, sharps and miscellaneous items on a
whiteboard in the OR for everyone on the team to reference. They can
never assume that counts indicated on packaged supplies are correct
and must count out individual items before documenting the initial
tally. If extra supplies are opened during the procedure, circulating
8 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 7
• ZONE OUT Circulating nurses and scrub techs should perform initial and closing counts in areas that are
free from distractions.
AORN
