After an open abdominal surgery, the OT nurse needs to do which of the following activities first before suturing? (Give priority answer)

1. A

   Disinfection of OT

2. B

   Change the gown

3. C

   Checking the sponge count and instrument counts before suturing

4. D

   Clean the instruments

Appeared in: NORCET 1 - 2020

Explanation

Listen in Hindi

• Checking sponge, sharp, and instrument counts is a critical safety step performed immediately before the closure of a body cavity.
• This action is essential to prevent Retained Surgical Items (RSIs), a serious and preventable complication that can lead to infection, pain, and the need for re-operation.
• It is a standard, non-negotiable protocol in operating rooms worldwide, often part of a formal 'Sign Out' phase of the surgical safety checklist.

Why Other Options Were Wrong

• Option A: Disinfection of the operating theater (terminal cleaning) is a post-procedural task.
• Option B: Changing a surgical gown is not a routine, scheduled step before closure; it is done on an as-needed basis.
• Option D: Cleaning and sterilization of instruments is a large-scale process that occurs in a separate department (Central Sterile Supply Department) after the surgery is completely finished.

Related Visual

Clinical Relevance

• Nursing practice connection: Safe nursing care depends on performing Priority nursing actions and surgical safety protocols in the operating room in the correct sequence, documenting the action clearly, and monitoring for the expected response.
• The nurse's role in leading and verifying the surgical count is a fundamental aspect of patient advocacy and ensuring safety in the perioperative environment.
• A failure in the counting process, leading to an RSI, is considered a serious medical error with significant legal and professional repercussions for the entire surgical team.
• What if the count is incorrect? If the final count does not match the initial baseline, the surgeon must be notified immediately. The closure is paused, and a systematic search is initiated. This can involve manually re-exploring the wound, checking drapes and waste bins, and may require an intraoperative X-ray to locate the missing item before the patient can safely leave the OR.

How to Approach the Question

• First, analyze the question to identify the specific context: the action must be the 'first' or 'priority' task for a nurse 'before suturing' in an 'open abdominal surgery'.
• This is a question about procedural sequence and safety priorities. Think about the logical flow of an operation: preparation, incision, procedure, closure, and post-procedure cleanup.
• Evaluate each option based on its timing within this sequence.
• Recognize that 'Disinfection of OT' and 'Clean the instruments' are post-procedure tasks that happen after the patient has left.
• Consider 'Change the gown'. This is an event-driven action (due to contamination), not a routine step before closure.
• Identify 'Checking the sponge count' as a critical, mandatory safety check that must occur immediately before a body cavity is closed to prevent leaving items inside the patient. This timing makes it the highest priority among the choices.

Concept Tested & Keywords

• Concept Tested: Priority nursing actions and surgical safety protocols in the operating room.
• Stem keywords: open abdominal surgery, OT nurse, first, before suturing, priority answer
• Lead-in keywords: first, priority

Question ID

QEV3_lVxO55tXxa5l-drnB

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 93-95