Risk factors for incorrect surgical count during surgery: An observational study.

Abstract

BACKGROUND\nIncorrect surgical counts are closely related to retained surgical items, which pose a threat to patients. However, the risk factors for incorrect surgical counts have not been identified yet.\n\n\nAIM\nTo identify the risk factors associated with incorrect surgical counts during surgery in a tertiary hospital.\n\n\nDESIGN\nAn observational case-control study.\n\n\nMETHODS\nSeventy cases of incorrect surgical counts were reviewed in this study. Data were collected from January 1, 2014, to April 4, 2019. For each case, we included four randomly selected control cases involving the same surgical procedures by the same surgeon within a 6-month period for comparison. The medical data of these cases were extracted for further statistical analysis.\n\n\nRESULTS\nA higher incidence of incorrect surgical counts was observed among surgical counts performed between 8:00\u2009a.m. to 12:00\u2009a.m., emergency operations, prolonged procedures, and/or after addition of surgical items.\n\n\nCONCLUSION\nProlonged surgical procedures, emergency operations, time of occurrence, and addition of surgical items were the risk factors related to incorrect surgical counts during surgery.\n\n\nSUMMARY STATEMENT\nWhat is already known about the topic? Incorrect surgical count is a perplexing problem during operation. Incorrect surgical count is closely associated with retained surgical items which can cause patient injury. The underlaying risk factors of incorrect surgical count were still unknown. What this paper adds? This was the first case-control study for incorrect surgical counts in China. The present research demonstrated that several risk factors were significantly associated with the occurrence of incorrect surgical counts, including the time period, the type of surgery, and the duration of the procedure. Vigilance should be maintained during an emergency operation or a long procedure to reduce the incidence of incorrect surgical counts. The implications of this paper: It is important for nurses to be aware of the factors that can interfere with correct surgical counts, thereby ensuring vigilance during emergency operations or long procedures. By identifying these risk factors, a more comprehensive safety policy in the operation room can be implemented to reduce incorrect surgical counts. Novel technological adjuncts should be promoted in the operating room gradually to improve overall patient safety.