Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Dry erase board is cleared of previous case information.
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Count is initiated in a timely manner: Prior to incision at start of case.
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Count is initiated in a timely manner: when wound closure begins.
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Count is initiated in a timely manner: when skin closure begins, prior to dressing or skin adhesive.
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Instrument counts are completed as appropriate (with open abdominal or thoracic wounds).
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Items added to the sterile field are noted on the dry erase count board or instrument count sheet immediately.
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Sponges discarded from the field are collected in a pocketed sponge count bag.
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If count is interrupted, the count is resumed with recounting of items currently being counted.
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Items are counted with circulator visualizing field and verbally participating.
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Hand off report to relief circulator includes report of any counted items removed from field and held for final counts.
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Counts are documented starting at the field, then to mayo stand, to back table, and off field.
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Counts are documented in EMR at the time they are completed.
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Any waived counts are documented including reason for omission.
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Appropriate actions are taken for count discrepancy (notify surgeon, notify charge nurse/ manager, x-ray).
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Trash and linen bags are not removed from the OR until wound closures and counts are completed.