Surgical count and patient safety in the perspective of the operating room circulating nurse

Authors

DOI:

https://doi.org/10.5327/10.5327/Z1414-4425201900010008

Keywords:

Enfermagem Perioperatória, Segurança do Paciente, Pesquisa em enfermagem, Assistência de enfermagem.

Abstract

Objective: To investigate the perspective of the operating room circulating nurse on surgical count for patient safety. Method: Qualitative exploratory
study, performed at the surgical center of a large hospital in the Northeast of Brazil, between January and March 2018. We carried out a Content
Analysis of the interviews conducted with 11 operating room circulating nurses using theoretical saturation. Results: The responses were organized in
two thematic categories – “Surgical count for patient safety” and “Flaws in the surgical count protocol” –, revealing the need to invest in practice change,
as most interviewees understood or acknowledged the importance of surgical count for patients. Conclusion: The relevance of surgical count is empirically
recognized and must be strengthened through actions that guarantee the understanding of the extent and impact of this practice on patient safety.

Author Biographies

Eduardo Tavares Gomes, Hospital das Clínicas da Universidade Federal de Pernambuco

Doutorando em Ciências pelo Programa de Pós-Graduação em Enfermagem em Saúde do Adulto da Escola de Enfermagem da Universidade de São Paulo

Maria Luciene dos Santos, Hospital das Clínicas da Universidade Federal de Pernambuco

Enfermeira. Especialista em Enfermagem em Oncologia - UPE. Especialista em Enfenfermagem em Estomaterapia - FENSG-UPE. Enfermeira Assistencial do Centro Cirúrgico do HC-UFPE

Sinairana Silva Santana Lins de Araújo, Hospital das Clínicas da Universidade Federal de Pernambuco

Enfermeira, especialista em Qualidade e Segurança no Cuidado ao Paciente. Enfermeira Assistencial do Centro Cirúrgico do HC-UFPE

Marcone César Tabosa Assunção, Hospital das Clínicas da Universidade Federal de Pernambuco

Enfermeiro, Mestre em Gestão e Economia da Saúde pela Universidade Federal de Pernambuco. Chefe da Unidade de Blocos Cirúrgicos do Hospital das Clínicas da Universidade Federal de Pernambuco.

Vilanice Alves de Araújo Püschel, Escola de Enfermagem da Universidade de São Paulo

Enfermeira, Doutora em Enfermagem pela Universidade de São Paulo. Professora Adjunta do Progama de Pós-Graduação em Enfermagem em Saúde do Adulto - PROESA-USP. Diretora do Centro Brasileiro para o Cuidado à Saúde Informado por Evidências: Centro de Excelência do Instituto Joanna Briggs (JBI Brasil)

References

Mc Arthur A. Operating Room: Surgical Counts Surname. Evidence Summary. Australia: The Joanna Briggs Institute. 2016

Stawicki S, Moffatt-Bruce S, Ahmed H, Anderson H, Balija T, Bernescu I, et al. Retained surgical items: a problem yet to be solved. J Am Coll Surg [Internet]. 2013 [cited 2018 Jun 20]; 216(1): 15-22. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23041050 DOI: 10.1016/j.jamcollsurg.2012.08.026.

World Health Organization. World Alliance for Patient Safety. Implementation manual surgical safety checklist. WHO: Geneva; 2008 [cited 2018 Jun 25]. Available from: http://www.who.int/patientsafety/safesurgery/tools_resources/SSSL_Manual_finalJun08.pdf?ua=1

World Health Organization. WHO guidelines for safe surgery - Safe surgery saves lives. WHO: Geneva; 2009. [cited 2018 Jun 25]. Available from: http://apps.who.int/iris/bitstream/handle/10665/44185/9789241598552_eng.pdf;jsessionid=F785D8684C05FBF825F6C7B183458C6A?sequence=1

Fontanella BJB, Luchesi BM, Saidel MGB, Ricas J, Turato ER, Melo DG. Amostragem em pesquisas qualitativas: proposta de procedimentos para constatar saturação teórica. Cad Saúde Pub [Internet]. 2011[cited 2018 Jun 20]; 27(2):389-394. Available from: http://www.scielo.br/pdf/csp/v27n2/20.pdf DOI: 10.1590/S0102-311X2011000200020

Bardin L. Análise de Conteúdo. 1.ed. Brasil: Ed 70; 2011, 280pp.

Caregnato RCA, Mutti R. Qualitative research: discourse analysis versus content analysis. Texto Contexto-Enferm [Internet]. 2006 [cited 2018 Jun 20]; 15(4): 679-84. Disponível em: http://www.scielo.br/pdf/tce/v15n4/v15n4a17.pdf DOI: 10.1590/S0104-07072006000400017

Ollaik LG, Ziller HM. Concepções de validade em pesquisas qualitativas. Educ Pesq [Internet]. 2012 [cited 2018 Jun 20]; 38(1):229-241. Available from: http://www.scielo.br/pdf/ep/v38n1/ep448.pdf DOI: 10.1590/S1517-97022012005000002.

Freitas PS, Mendes KDS, Galvão CM. Surgical count process: evidence for patient safety. Rev Gaúcha Enferm [Internet]. 2016 [cited 2018 Jun 20]; 37(4):e66877. Available from: http://www.scielo.br/pdf/rgenf/v37n4/0102-6933-rgenf-1983-144720160466877.pdf DOI: 10.1590/1983-1447.2016.04.66877

Wan W, Le T, Riskin L, Macario A. Improving safety in the operating room: A systematic literature review of retained surgical sponges. Curr Opin Anaesthesiol [Internet]. 2009 [cited 2018 Jun 20]; 22(2):207-214. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19390247 DOI: 10.1097/ACO.0b013e328324f82d.

Greenberg C, Diaz-Flores R, Lipsitz S, Regenbogen S, Mulholland L, Mearn F, et al. Bar-coding surgical sponges to improve safety: a randomized control trial. Ann Surg [Internet]. 2008 [cited 2018 Jun 20]; 247(4):612-6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18362623 DOI: 10.1097/SLA.0b013e3181656cd5.

Harihran D, Lobo DN. Retained surgical sponges, needles and instruments. Ann R Coll Surg Engl [Internet]. 2013 [cited 2018 Jun 20]; 95(2): 87–92. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098594/ DOI: 10.1308/003588413X13511609957218

Gawande A, Studdert D, Orav E, Brennan T. Zinner M. Risk factors for retained instruments and sponges after surgery. N Engl J Med [Internet]. 2003 [cited 2018 Jun 20]. 348:229-235. Available from: https://www.nejm.org/doi/full/10.1056/NEJMsa021721 DOI: 10.1056/NEJMsa021721

Williams TL, Tung DK, Steelman VM, Chang PK, Szekendi MK. Retained surgical sponges: findings from incident reports and a cost-benefit analysis of radiofrequency technology. J Am Coll Surg [Internet]. 2014 [cited 2018 Jun 20]; 219(3):354-64. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25081938 DOI: 10.1016/j.jamcollsurg.2014.03.052.

Greenberg C, Regenbogen S, Lipsitz S, Diaz-Flores R, Gawande A. The frequency and significance of discrepancies in the surgical count. Ann Surg [Internet]. 2008 [cited 2018 Jun 20]; 248(2): 337-41. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18650646 DOI: 10.1097/SLA.0b013e318181c9a3.

Norton EK, Micheli AJ, Gedney J, Felkerson TM. A nurse-led approach to developing and implementing a collaborative count policy. AORN J [Internet]. 2012 [cited 2018 Jun 20]; 95(2):222-7. Available from: https://aornjournal.onlinelibrary.wiley.com/doi/full/10.1016/j.aorn.2011.11.009 DOI: https://doi.org/10.1016/j.aorn.2011.11.009

Moffatt-Bruce SD, Cook CH, Steinberg SM, Stawicki SP. Risk factors for retained surgical items: a meta-analysis and proposed risk stratification system. J Surg Res [Internet]. 2014 [cited 2018 Jun 20]; 190(2):429-36. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24953990 DOI: 10.1016/j.jss.2014.05.044.

Goldberg J, Feldman D. Implementing AORN recommended practices for prevention of retained surgical items. AORN J [Internet]. 2012 [cited 2018 Jun 20]; 95: 205-16. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22283912 DOI: 10.1016/j.aorn.2011.11.010.

Norton E, Martin C, Micheli A. Patients count on it: An initiative to reduce incorrect counts and prevent retained surgical items. AORN J [Internet]. 2012 [cited 2018 Jun 20]; 95(1): 109-121. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22201575 DOI: 10.1016/j.aorn.2011.06.007.

Published

2019-04-10

How to Cite

Gomes, E. T., dos Santos, M. L., de Araújo, S. S. S. L., Assunção, M. C. T., & Püschel, V. A. de A. (2019). Surgical count and patient safety in the perspective of the operating room circulating nurse. Revista SOBECC, 24(1), 37–42. https://doi.org/10.5327/10.5327/Z1414-4425201900010008

Issue

Section

ORIGINAL ARTICLES