The sterile processing department is where instruments go to be cleaned, counted, put back in order, and sterilized.
But how do they know what instruments go in each set?
What if I wanted a minor tray?
There is a count sheet for that.
This is a standardized to the hospital form that lists all the instruments, in order, and lists how many there are of each instrument that can be expected.
Ideally, the catalog number of the instrument is listed, along with the manufacturer. This makes it easier to be reordered in case of accidental loss.
Not in a patient.
We covered that in Counting Basics #4.
Why do counts exist? It allows us to be relatively confident that what goes in comes out.
Barring emergency cases (the cut or die type) or patients with a large cavity.
The count sheet is begun in sterile processing during tray makeup.
All instruments in the tray are counted and noted on the sheet.
And the tray is sterilized.
But sometimes the count sheet and the tray do not match. What then?
Yeah, SPD techs are allowed to be human.
Just adjust the count sheet and continue with the count.
To you, the count is right in front of you.
To the SPD tech, the tray may have been one of several of the same kind that was assembled at that time. And it might have been days ago, depending on the frequency of use.
And that is why we count again. Comparing it with the count sheet.
Because all that matters is that somewhere, sometime there is an agreement before the patient is in the room.
And the count sheet is kept and maintained, added to if needed, and counted off again as the surgeon is closing.
Is this elementary? Yes.
Does anything better exist? No.
An option would be to x-ray every single person upon closure, exposing them to x-ray unnecessarily, costing them more.
Some places do this.
Of course, some places think that fewer counts are a good thing.
A retained surgical item can cost the hospital thousands and thousands of dollars for retrieval.
A retained surgical item can cost the patient another surgery and recovery period.
A retained surgical item can cost the hospital system big time due to lawsuits.
Follow the policy of your hospital. No matter what it takes. No matter the pressure from the surgeon to just get it done already.
You are not there to keep the surgeon on time or happy.
You are there to keep the patient safe.