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Family name:Perioperative Count RecordGiven name(s):For EMR Literate: ............... / ............... / ............... Page: ................ of ................ Address:Facility:Date of birth:............................................................................................................
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How to fill out perioperative count record form
How to fill out perioperative count record form
01
Start by collecting all necessary information and materials, such as the patient's name, identification number, and procedure being performed.
02
Open the perioperative count record form and fill in the required information at the top, including the date and time of the procedure.
03
Prior to the start of the procedure, count and document all surgical instruments, sponges, needles, and other materials being used.
04
Clearly label each count section on the form, indicating the specific item being counted.
05
During the procedure, maintain a vigilant count of all items being used and document any additions or subtractions from the initial count.
06
If there are any discrepancies or missing items, communicate this immediately to the surgical team and document the issue on the form.
07
At the end of the procedure, re-count all items and ensure they are accounted for before completing the final count section of the form.
08
Sign and date the form to authenticate the count record.
09
Submit the completed perioperative count record form to the appropriate personnel for review and filing.
Who needs perioperative count record form?
01
The perioperative count record form is needed by healthcare professionals involved in surgical procedures, including surgeons, nurses, anesthesiologists, and surgical technologists.
02
This form is essential for maintaining accurate records of all surgical instruments and materials used during a procedure, as well as identifying any potential discrepancies or missing items.
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What is perioperative count record form?
Perioperative count record form is a document used to track and record the count of surgical instruments and other items used during a surgical procedure.
Who is required to file perioperative count record form?
The surgical team including surgeons, nurses, and surgical technicians are required to file perioperative count record form.
How to fill out perioperative count record form?
Perioperative count record form is filled out by documenting the count of each instrument and item before and after the surgical procedure.
What is the purpose of perioperative count record form?
The purpose of perioperative count record form is to ensure that all surgical instruments and items are properly accounted for before and after the surgical procedure to prevent any post-operative complications.
What information must be reported on perioperative count record form?
The perioperative count record form must include details of each instrument and item used, the initial count, the final count, and any discrepancies found.
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