Uniform counting methods and requirements
3.4.1 Before surgery (1) The doctor shall not start the operation before the surgical items have been accurately counted. (2) During the count, the circulating nurse and the hand-washing nurse will sing the order twice at the same time. That is, after the hand-washing nurse reports the name and number of the instruments and dressings, the circulating nurse must record it while repeating it. After all counts and records are completed, the circulating nurse will place the record sheet in a place where the hand-washing nurse can clearly see it, and the hand-washing nurse will review and verify it to remind and correct errors. (3) The handwashing nurse must count and record the active screw caps. The double-layer yarn needs to be opened one by one for inventory, and the bare edges should be placed neatly outside.
3.4.2 During the operation (1) No one is allowed to touch the items that have been counted without the permission of the hand-washing nurse and the circulating nurse; when items are to be filled deep in the surgical area, the hand-washing nurse must remember to stuff them The name and quantity of the object. Items added during the operation should be recorded promptly. Use a "+" sign after the preoperative count number to connect each additional amount. Objects dropped on the operating table should be found promptly and placed in the basin containing contaminated dressings. (2) The name and quantity of items that need to be left in the patient's body due to treatment must be recorded in detail by the circulating nurse in the special circumstances column after the operation in the "Surgical Nursing Record Sheet", and must be signed by the doctor after verification. (3) During major surgery and critical surgery, nurses should persist until the end of the surgery and are not allowed to change people for meals or other work midway. When a substitution is necessary under special circumstances, the handover personnel should be present to hand over the number of instruments, dressings and other items in person, and must sign their signatures.
3.4.3 Before closing the body cavity, the surgeon should be proactively reminded to take out all the items in the body cavity and then count them. The circulating nurse places the used gauze on the disposable plastic sheet and counts them, arranging them in 5 blocks and 1 row, so that the hand-washing nurse can see the number clearly. The number on the table and the number under the table are added to equal the preoperative number and the additional number. The incision can be closed only after confirmation. If the same patient requires multiple incisions, all items must be counted as usual when closing each incision, and the items after counting are kept in the operating room for future reference. This improves the accuracy of inventory checks and prevents errors in the number of instruments and dressings.
3.4.4 What to do when the counted numbers do not match If the counted numbers do not match, report it immediately to the surgeon. If the numbers still do not match after re-counting, prepare a C-arm machine to search. If the number still cannot be found after fluoroscopy, The operation should be completed after a joint analysis with the operating surgeon to confirm that no body cavity remains, and the process and handling measures should be recorded on the "Surgical Nursing Record Sheet". And signed by a nurse doctor.
3.5 Inventory system for laparoscopic surgery and surface surgery. Open surgical instruments should be routinely prepared for laparoscopic surgery and all inventory should be carried out to ensure accurate inventory and smooth operation when changing to open surgery, preventing There is a hidden danger of counting errors due to the rush of time; debridement and suturing, mass resection, removal of foreign bodies on the body surface, removal of internal fixation of fractures, etc. require the circulating nurse and the surgeon to count the gauze and suture needles together and record them, and each signature after the operation .