count sheets

[pavgoblue]

Hi, I'm looking for info to find out how others are including count sheets to small frag and mod hand sets. We include count sheets inside all of our other instrument sets(using non-toxic sharpies) but there has been some discussion as to whether this is good technique when implantable hardware is included in small sets.
Thanks

[Sno]

I have been to facilities that tape them to the outside wrap. It worked fine as an OR nurse looking for sets to pull, its easier to read the paper then some of the handwriting.

[irma vasquez]

Hi, in our hospital that is what we do on any wrap tray we put it on top of the wraper and on the tray we are still placing the count sheet in side the tray, is anybody doing it diffrently.
Thanks

[allis]

The ABACUS system is used in my hospital. Count sheets are taped on the wrapping paper outside trays. Even before we got ABACUS, we never put tray lists with instruments. I remember only one list that was put inside with instruments, but I could convince management to stop that practice. I personally don't think it's appropriate to have anything else than integrators/indicators with instruments on trays.

[Catherine Davis]

We still put the count sheet on top of the 2nd. flap when wrapping and inside the rigid container. We still use the count sheet for the initial OR count and the decontam count. If it is taped to the wrapper how is this possible??

[Harvey Johnson]

This subject has been flogged repeatedly on this forum, apparently without changing any minds. :rolleyes:
If you do a search you will see the past threads regarding count sheets inside trays.
We have been folding count sheets inside approved for sterilization envelopes, placing them inside trays without incident for years.
Ink or paper lint is not an issue inside approved for sterilization envelopes.
We have challenge tested sheets and envelopes inside trays with integrators and BI's six ways from Sunday without a positive.
In the long run, following what is considered best practice for your facility is the correct course. (remembering always to keep it between the navigational buoys!) ;)

[ksuemc]

We use count sheets in all of our sets. We fold them in HALF so that the ink is ink to ink. We place an indicator on one side that is faced up. Hope this helps.

[sunshine]

Well glad it's still a hot topic. Thinking we were the only place still putting count sheets in sets.
I like the idea of putting it in the pouch. I think OR could find it :) But it must be a certain type pouch.....correct?

[Harvey Johnson]

We use the approved for sterilization paper pouches (not peel packs!) from healthmark for count sheets, small parts and instruments previously wrapped inside towels.

[Karla]

It seems like such a huge issue, but after doing it, its not. I have taken them out and the hospital OR staff support it. They grab a count sheet when they pick a tray and I have tags for pans and stickers for wrapped items that alert them to anything that may be missing in the pan, which should be rare. That change they love! I wont say it was easy to think of every possible problem this could cause but the transition was easier for he OR then I thought it would be. Plus I have referance books with all the count sheets in the rooms just incase they need to look to see what another pan may have if they are looking for something....its doable, so just go for it.

[jtruitt]

Our department removed the count sheets from the canisters and the wrapped trays a couple of years ago. I am an old OR nurse and still abide by the if in doubt throw it out. We keep the counts sheets for each load sterilized clipped together and loop them over the handle of the canister, on top of wrapped trays and secure with cellophane tape after trays are cooled. We tried applying them to the handles and running them through the cycle but the ink was smeared. Hopefully we will have a final answer soon.

[Karla]

Good for you for taking the sheets out of the pans. I can see if you dont have support to do this, but if you do, just do it, take them out! Its easy!

:D

[Harvey Johnson]

Whatever your hospital establishes as best practice policy for your facility obviously is whats best for your facility. Not all will agree on your best practice, that does not make their practice wrong for them, just wrong for you.
With AORN mandating instrument counts pre and post procedure while in the OR, the most efficient and accurate method for us is to sterilize the sealed count sheets in the trays, no worries about contamination, lost or not up to date sheets or inaccurate counts.

[Karla]

"Whatever your hospital establishes as best practice policy for your facility obviously is whats best for your facility."

That is exactly right.. The recomendation is sheets should not be in pans, and I am not comfortable with sheets in the pans in a pouch or not so we chose against this, our counts are accurate and we have a process in place for updating these sheets so this works for us. Like Harvey said, do what is right for you that follows AORN/AAMI. :D