perio 2 b

Question 1

In each phase in surgery

Answer 1

a checklist coordinator must confirm that the
surgery team has completed the listed tasks before it
proceeds with the operation.

Question 2

Why? In each phase in surgery checks

Answer 2

Aim is to reduce the risk of elective procedures being
carried out on the wrong patient or part of the body.
- Can cause serious harm and distress to patients, their
families and the healthcare professionals involved in their
care.
- Costly to the patient who may require further treatment or
medications
- Costly to health provider who has to spend time and
resources fixing mistakes

Question 3

Who carries out the checklist?

Answer 3

All members of the surgical team owe the patient a duty of care
to perform the correct surgery on the correct site on the correct
patient.
- The surgeon, anaesthetist and nursing team must consult and
agree to ensure the correct patient, procedure, site and side

Question 4

who is responsible in the theatre

Answer 4

Adopting a “team approach” in the theatre will reduce risk but
the operating surgeon is ultimately responsible

Question 5

Surgical Count

What is it…

Answer 5

• A method of accounting for ALL items used in the sterile
  field during a procedure (‘accountable’ and surgical
  instruments/trays)

Question 6

Surgical Count Why…

Answer 6

• Retained item can be a source of SSI (Surgical site infection)
• Infection control (fluid contamination, sharps)
• Inventory control (expensive instruments not discarded)
• Potential lawsuit (patient vs. surgeon vs. instrument
  nurse)

Question 7

Surgical Count

How…

Answer 7

• Conducted by two nurses (one must be RN)
• Must count out loud and in unison, and documented
  accordingly
• Both nurses must be able to see accountable item
• If you open an accountable, you add it to the count sheet
• First count must be performed before case starts
• Second and third counts when closing (per cavity)
• After first count, all bins and linen bags must stay in theatre!
  (and changed between cases)

Question 8

Surgical Count

If something goes missing…

Answer 8

CHECK EVERYWHERE!! bins, linen, under table, under shoes….

• Alert surgical team and have them check cavity
• Inform in-charge nurse
• If unable to find, an x-ray will need to be ordered
• Document in patient’s notes
• Complete incident report

Question 9

Accountable items

Answer 9

Items, which by their nature, at risk of being retained in the
patient. Such items requiring mandatory documentation are to
include, but may not be limited to..

Question 10

accouantable included as mandatory count

Answer 10

• Absorbent items:
• Sharps such as:
  scalpel blades, diathermy tips.
• Vascular items:
• Retraction devices:

Question 11

• Absorbent items

Answer 11

swabs, ‘patties’, cherries’, ‘peanuts’, eye

swabs (strolls), gauze strips, cotton wool balls, sponges.

Question 12

• Sharps

Answer 12

needles (ordinary and atraumatic), detachable

Question 13

• Vascular items:

Answer 13

haemostats (artery forceps), bulldog clamps,
vessel loops (ligaloops), snuggers, snares, tapes, ligareels,ligaboots (rubber shods).

Question 14

Retraction devices

Answer 14

fish hooks, visceral retractors (‘fish’)