Gjenglemt utstyr - anbefalte kontrollrutiner. En kunnskapsbasert fagprosedyre for kirurgisk telling

Abstract

Introduction: Norwegian Patient Injury Compensation refers to 84 events of retained surgical items (RSI) during surgery in Norway in the last ten years. Perioperative nurses have an important function in preventing RSI. Review of the research revealed many preventive measures for RSI, as well as risks and consequences associated with such events. Lack of standardized procedure shows the need to develop an evidence-based clinical procedure.

Methods: Norwegian Institute of Public Health’s method and minimum requirements for the preparation of evidence-based clinical procedures, based on AGREE II, have been used in the preparation of this clinical procedure. We conducted a systematic review of associated literature in cooperation with a librarian in the period August 2016 to March 2017. The search was undertaken in electronic databases such as NICE, Cinahl, Medline and The Cochrane Library. Norwegian Institute of Public Health’s appraisal tools are used for critical assessment of the studies. We used GRADE for grading of the included studies, while the included guideline was graded with AGREE II Rating Scale.

Results: Nine studies form the knowledgebase for the clinical procedure. Included studies constitute one international guideline, three systematic reviews, three reviews, one qualitative study and one audit. The recommendations given are based on what research shows about risk factors, what time surgical count should be performed, which type of items involved and how it should be documented. Along with input from the project group is an evidence-based clinical procedure developed with associated algorithms.

Conclusion: In line with the special competence, the perioperative nurses are responsible to perform correct surgical count. An evidence-based clinical procedure that provides specific recommendations for surgical counts helps to prevent complications, and thereby ensure patient safety.