AORN AORN Surgical Counts and Accountability 1 — Questions and Answers
Question 1: When should the initial surgical count be performed according to AORN recommended practices?
- Before the procedure begins, before incision (Correct answer)
- After the patient is draped and positioned
- After the first incision is made
- At any time before wound closure
Correct answer: Before the procedure begins, before incision
AORN recommends the initial count be performed before the procedure begins and before the incision to establish a baseline of all countable items.
Question 2: Which items are included in the standardized perioperative surgical count per AORN guidelines?
- Sponges, sharps, instruments, and miscellaneous items (Correct answer)
- Sponges and sharps only
- Instruments and sutures only
- Only items that could be retained in a body cavity
Correct answer: Sponges, sharps, instruments, and miscellaneous items
AORN's recommended practices include counting sponges, sharps, instruments, and any miscellaneous items (e.g., vessel loops, electrosurgical tips) that could be retained.
Question 3: According to AORN, how should surgical counts be performed to ensure accuracy?
- Concurrently and audibly by both the scrub person and circulating nurse (Correct answer)
- Silently by the scrub person alone
- By the circulating nurse watching the scrub person count
- By the surgeon and scrub person together
Correct answer: Concurrently and audibly by both the scrub person and circulating nurse
Counts must be performed concurrently and audibly by both the scrub person and circulating nurse to reduce the risk of counting errors.
Question 4: What action should be taken if a surgical count discrepancy is identified before wound closure?
- Immediately notify the surgeon, perform a wound search, and obtain an X-ray if the item is not found (Correct answer)
- Close the wound and document the discrepancy
- Recount once and proceed if the recount is consistent
- Notify the charge nurse and continue the procedure
Correct answer: Immediately notify the surgeon, perform a wound search, and obtain an X-ray if the item is not found
A count discrepancy requires immediate notification of the surgeon, a thorough wound search, and an intraoperative X-ray if the missing item is not located.
Question 5: When should the closing count be performed during surgery?
- Before closure of a body cavity, hollow organ, or wound (Correct answer)
- After skin closure is complete
- Only if a discrepancy occurred during the initial count
- At the discretion of the surgeon
Correct answer: Before closure of a body cavity, hollow organ, or wound
The closing count should be performed before closure of any body cavity, hollow organ, or the wound to verify all items are accounted for.
Question 6: Which of the following is the correct method for counting sponges on the sterile field?
- Counting sponges one at a time while separated from the group (Correct answer)
- Counting sponges in their original package groupings
- Counting only used sponges at the end of the case
- Counting sponges only when a discrepancy is suspected
Correct answer: Counting sponges one at a time while separated from the group
Sponges must be separated individually and counted one at a time to prevent miscounting caused by sponges sticking together.
AORN AORN Surgical Counts and Accountability 1
When should the initial surgical count be performed according to AORN recommended practices?