Key result
Perioperative surgical counts demonstrate 60% compliance with ACORN standards, limited by environmental and team barriers.
Why the study?
The study was conducted to systematically measure perioperative nurses' surgical count practices, assess conformity with standardised processes, and identify barriers and enablers influencing their practices.
Observational (n=83)
No
Compliance with standardized surgical count processes among perioperative nurses was lower than expected at 60%, influenced by various environmental and personnel factors.
Low compliance with surgical counts signals perioperative safety gaps; hypothesis-generating for interventions targeting environmental and team barriers.
Objective: To systematically measure and describe perioperative nurses’ surgical count practices using the Surgical Count Observational Tool, to measure conformity with standardised processes and identify barriers and enablers influencing nurses’ practices. Sample and setting: A large public tertiary hospital in Western Australia Methods: The Surgical Count Observational Tool (SCOT) was developed using the Content Validity Index over two Delphi panel rounds and then pilot tested. Individual observations were analysed according to 14 criteria based on the 2016 Australian College of Perioperative Nurses (ACORN) standard ‘Management of accountable items used during surgery and procedures’1. Count processes were observed over two consecutive weeks across six specialist perioperative teams including nurses, surgeons, anaesthetists and technicians to measure compliance with the ACORN standard. The SCOT and a field diary were then used in an observational study of 83 nursing staff, including 54 circulating nurses and 29 instrument nurses, over a period of 57 hours. Interrater reliability was calculated using Cohen’s kappa. Descriptive statistics were used to analyse observational data. Results: Of the 1268 count practices observed, 759 were compliant with the ACORN standard, representing a 60 per cent compliance rate. Conclusion: Consistency and compliance rates were lower than expected. Patient, case, environmental factors and expectations of surgeons and co-workers were observed to act as barriers to best practice in perioperative nurses undertaking a surgical count, while nurse’s knowledge was observed to act as an enabler.
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Warwick et al. (2021) conducted an observational in Surgical count practices (n=83). Surgical count practices was evaluated on Compliance with the ACORN standard. Among 83 perioperative nurses, 60% of 1268 observed surgical count practices were compliant with the ACORN standard, with various environmental and team factors acting as barriers to best practice.
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