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Hip With the Times - July 2017 - 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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ly summoning the powers of memory and enumeration, you should record one count — on a standardized template in a location that's visi- ble to the surgical team — before starting the next. That's just one of the many lessons AORN gleaned from psychological studies on counting that helped shape its updated Guideline for Prevention of Retained Surgical Items (osmag.net/KRkGa4), says Amber Wood, MSN, RN, CNOR, CIC, FAPIC, senior perioperative practice specialist with AORN. Studies have also shown that you can't count accurately beyond 2 when you're distracted. If you're interrupted during a count, don't resume counting but rather start over from zero, says Ms. Wood. Also, 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 dis- traction and the patient needs 100% of your attention, so it's better to do the initial count in the relatively quiet few minutes before the patient enters the room. If the baseline count's not accurate, none of the others will be accurate, says Ms. Wood. Minimizing distractions during initial and closing counts is one of the best ways to prevent retained items, says Mary C. Fearon, MSN, RN, CNOR, a perioperative practice specialist for AORN. It's best to create a "no-interruption" zone, where nurses and surgical techs con- ducting counts are left to focus only on the task at hand. Some facili- ties have even flashed "INITIAL COUNT IN PROGRESS" on surgical monitors to alert the rest of the team to keep distractions at a minimum. Finally, it's also a good idea to line kick buckets and sponge recepta- cles with clear plastic bags. Red biohazard bags make it difficult to see bloody used sponges, and white bags make it difficult to see unused sponges, says Verna C. Gibbs, MD, the director of NoThing Left Behind, a staff surgeon at the San Francisco VA Medical Center and a clinical professor of surgery at the University of California, San Francisco. OSM 5 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 • J U L Y 2 0 1 7 SURGICAL ERRORS

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