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Sponge and Instrument Counts

In most hospitals, the operating room nursing personnel are responsible for ensuring that sponge and instrument counts are correctly carried out and documented. The surgeon should always ask the operating room nurse the count and whether it is correct. This verification should be included in the operative note, including the name of the nurse certifying the count. Under no circumstances should a surgeon pressure the nursing staff to ignore an incorrect count. If the count is incorrect, the appropriate steps should be taken to find what is missing. If the missing item does not turn up with a properly conducted search, every detail of the search should be documented and the surgery completed. The patient should be fully informed as soon as feasible. Under no circumstances should the information be withheld from the patient.

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