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Accounting for Small Surgical Devices in Neurosurgery

Accounting for Small Surgical Devices in Neurosurgery

July 26th, 2017 - Salem, MA - The accurate counting of small surgical instruments can save time and money.


Small devices such as patties and clips have become integral components of a neurosurgical procedure.  However, while rare, an incorrect account of the number of these small devices used in a procedure can occur.  This results in additional time and resources in order to ensure no devices were left behind.  To help with the accounting process, x-ray detectable markers have become standard components in neurosurgical patties allowing for the patties to be identified more easily and thereby helping to save time and money.  Furthermore, the neurosurgical patties are supplied with counting cards that provide a simple and effective way of monitoring the number of patties used. 


Despite these benefits, there is still the practice of cutting larger strips to a desired size and/or shape.  This can result in additional problems, as the number of pieces used in a procedure can change throughout the duration.  While AORN standards indicate that the number of devices used must be reconciled at the end of a procedure, the specific techniques to accomplish this are not outlined.  In a study performed in the United Kingdom, 18 centers were contacted and 11 responded indicating they did use strips and, of those 11, 9 responded indicating that they cut the strips to the desired size and shape. However, when asked how they account for this practice, 4 responded indicating that they did not count them and 1 responded that they count each original strip as a single piece, even if it had been cut into multiple pieces.  In addition, only 56% of centers contacted indicated they counted surgical patties and 38% of the centers contacted stated that they do not count the Raney clips.

The result of the survey indicates that there does not appear to be a standardized method of accounting these small surgical devices.  This was most evident in the practice of accounting for the cutting of the strips.  Only one center responded that they used precut commercially available solutions.  The benefit of commercially available solutions is that it would assist OR practitioners in the counting process and help standardize the counting technique.


For more information on the study:

Mardell, A. and Davies, A. “Accounting for specialist items in neurosurgery.” J Perioper Pract. 2012, Sep; 22(9):293-295.

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