Development and implementation of practice guidelines to prevent retained surgical items and surgical items count sheet in Minimally Invasive Cardiothoracic Surgery
Keywords:
implementation guidelines, surgical items count sheet, prevention of retained surgical items, minimally invasive cardiothoracic surgeryAbstract
This developmental and evaluative research aimed to: 1) develop implementation guidelines for the prevention of retained surgical items for minimally invasive cardiothoracic surgery (MICS) and design comprehensive surgical items count sheet suitable for the specific context of MICS; and 2) evaluate the effectiveness of the implemented guidelines and the newly developed count sheet. The sample group consisted of 30 registered nurses working at the Cardiothoracic Surgery Operating Theater, Faculty of Medicine Ramathibodi Hospital. Research instruments included an audit checklist for evaluating compliance with the guidelines and a satisfaction assessment form regarding the surgical items count sheet used in MICS. Data were analyzed using descriptive statistics, including percentage, mean, and standard deviation.
The results demonstrated that compliance with implementation guidelines for preventing retained surgical items for MICS was at a very high level across all components: (1) the counting process, (2) management of swabs, (3) handling of sharp objects, (4) management of surgical instruments, and (5) procedures in the event of an incomplete count. Notably, compliance in the instrument management category was rated at the highest level. In addition, nurse satisfaction with the surgical items count sheet was very high across all dimensions: (1) content clarity, (2) formatting, and (3) perceived benefits and practical application. Among these, the “benefits and application” dimension received the highest satisfaction score (Mean = 4.84, SD = 0.243). The findings from this research can be further applied and used as a standard practice in minimally invasive cardiothoracic surgery. It is recommended to include an analysis of the problems and obstacles that lead to discrepancies in the counting of retained surgical items. Additionally, the development of innovations or devices to reduce risks in the counting process should be encouraged. Continuous monitoring and evaluation should be conducted to enhance the effectiveness of these guidelines.
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