Abstract:
Background: The retained surgical item is a critical double burden to the patients and their families. One way of minimizing the risks of this critical burden is the surgical counting process which is the method most applicable and observed in developing countries.
Aim: To determine the knowledge and practice towards surgical counting safety practices among operating room nurses and midwives at referral teaching hospitals in Rwanda.
Methodology: A non-experimental, cross-sectional descriptive study was conducted at four referral teaching hospitals. The stratified random sampling was used to select 160 nurses and midwives working in the operating rooms. Data were collected using self-administered questionnaire and observation checklist. Data were entered in Statistical Package for Social Sciences (SPSS version 21.0) and analyzed by statistical tests (Descriptive statistics, bivariate analysis & multivariate logistic regression) and presented in the tables. The ethical principles were valued.
Results: Level of knowledge was poor at the proportion of 78, 2% by 154respondents and poor practice of surgical counts safety (57.69%) was also reported by the respondents. Only 23 (65.7%) from 35 observed participants performed surgical counts initially. Shortage of staff and long procedures influence surgical counting at the agreement rate of 87.2 %( n=136/156) of the respondents respectively. Also 83.9% agreed that communication and interpersonal difficulties among staff influence surgical counting practices. Chi- square test exposed a statistical significant association between observed practice of surgical counting and demographic characteristics: gender and working experience with p-value of p≤0.015&p≤0.04 respectively. Multivariate analysis also showed that surgical count practice associated with demographic data of the respondents influence positively the counting [Gender (OR: 3.030562; p≤0.027); working experience (OR; 9.215279; p ≤0.002)]. Conclusion: Lack of knowledge and poor practice of surgical counting safety practices were confirmed by the respondents and observed by the researcher. Factors influencing surgical counting safety practices highlighted by the respondents are Staff shortage, long procedures, communication and interpersonal difficulties. Need assessment is essential to be conducted and to properly train operating rooms nurses& midwives on surgical counting even the development of innovative surgical counting guidelines
