Two statements are given below:Statement I: Retained surgical bodies are any foreign bodies left inside the patient after the operation.Statement II: To prevent retained surgical bodies the nurse must count surgical items before the skin incision.Choose the correct answer:

1. A

   Both Statement I and II are correct

2. B

   Statement I is correct but Statement II is incorrect

3. C

   Statement I is incorrect but Statement II is correct

4. D

   Both Statement I and II are incorrect

Appeared in: BHU NO - 12 April 2024

Explanation

• Statement I provides the correct and standard definition of a retained surgical body (RSB) or retained surgical item (RSI).
• Statement II is incorrect because it describes an incomplete safety protocol. Preventing RSBs requires multiple counts, not just a single count before the incision.
• The most critical counts for preventing RSBs are those performed immediately before the closure of a body cavity and again before the final skin closure.
• Relying solely on a pre-incisional count is insufficient as it does not account for items used and potentially misplaced during the surgical procedure itself.

Why Other Options Were Wrong

• Option A: This option is incorrect because Statement II is false. The process described in Statement II is an incomplete and therefore inadequate method for preventing retained surgical bodies.
• Option C: This option is incorrect because Statement I is a factually correct definition, while Statement II describes an incorrect and incomplete procedure.
• Option D: This option is incorrect because Statement I is a correct and accurate definition of retained surgical bodies.

Related Visual

Clinical Relevance

• Nursing practice connection: Safe nursing care depends on performing Surgical Safety and Prevention of Retained Surgical Items in the correct sequence, documenting the action clearly, and monitoring for the expected response.
• The circulating nurse and scrub nurse share primary responsibility for surgical counts. This is a critical patient advocacy role, as the patient is vulnerable under anesthesia.
• A retained surgical item is considered a serious reportable event and a form of medical negligence. It can lead to severe patient harm, including infection, sepsis, organ perforation, and the need for re-operation.
• What if? - If a count is incorrect (a discrepancy is found), the procedure must be paused. The surgeon must be notified immediately, and a systematic search of the surgical field, trash, and surrounding area must be conducted. If the item is not found, an intraoperative X-ray is typically required before the patient leaves the operating room.

How to Approach the Question

• First, analyze Statement I for its factual accuracy. Is this the correct definition of a 'retained surgical body'?
• Next, analyze Statement II. Evaluate the described action ('count surgical items before the skin incision') as a method 'to prevent' the problem. Ask yourself: Is this action sufficient and complete according to standard nursing protocol?
• Recall or look up the standard procedure for surgical counts. Note that it involves multiple steps at different times.
• Compare the action in Statement II to the full, correct procedure. Recognize that because Statement II presents an incomplete process as the solution, it is functionally incorrect in a safety-critical context.
• Based on your analysis of each statement's validity, select the option that accurately reflects your findings (e.g., I is correct, II is incorrect).

Concept Tested & Keywords

• Concept Tested: Surgical Safety and Prevention of Retained Surgical Items
• Stem keywords: Retained surgical bodies, foreign bodies, operation, surgical items, count, skin incision
• Lead-in keywords: Choose the correct answer

Question ID

QEdf3TKz7aLhCPXTW65Sxb

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 pp. 87-89, 71-73