Wednesday, October 23, 2013

Surgical Count :a team work

To make a Doctor Successful,it is hard work of a complete team including assistant surgeons,Anaesthetists,Scrub Nurse,Circulatin Nurse and OT Techinicians.The chief Doctor is the face of all the activities and the contace point for the patient but the fact remains that to give them a good surgical outcome a complete team is working hard and well coordinated.A lack in coordination can lead to mistakes which can compromise on surgical saftey despite all the competence of the surgeon.
Let me give you an example.To ensure the a surgery goes safely,before the surgeon starts the surgery the Scrub Nurse counts the Mops,Gauzes and instruments and the circulating nurse puts it on a white board in the OT.All the Mops and swabs aren't opened all at once but on demand of a busy operating surgeon who isn't supposed to keep a swab count,the circulating nurse hands it over to the scrub nurse.They count it together.Once the surgery is over and before the abdomen is closed the surgeon asks the scrub nurse to recount and confirm loudly that the initial count matched the second count.Again the scrub nurse with a circulating nurse double checks.Two scrub nurse or two circulating nurse are not supposed to count it between themselves.It has to be a circulating and scrub nurse.If in between scrub or circulating nurse leaves inbetween the surgery the documents are recounted ,documented and handed over all afresh to the new member of the operating team.
After which surgeon starts the closure of abdomen.
Once the abdomen is closed once again the count is correct is asked loudly by the surgeon and is confirmed by the scrub nurse.
After which the Scrub and circulating nurse sign on a WHO recommeneded saftey check list and also tick that the Surgeon has been informed.And finally surgeon signs that she has been informed.
So if next time you hear a story that a doctor left a foreign body inside ,you know it isn't the butcher negligent doctor.She was not supposed to count the mops but to rely on the team with whom they have been working for years..
So a teamwork which is well coordinated is very important for patient safety.


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