Peri-operative complications or associated adverse effects are to be prevented and managed using effective management strategies. One of the essential objectives to ensure surgical safety is the prevention of accidental retention of surgical items (RSIs)in surgical wounds. RSIs are rare medical errors that have the potential to cause significant harm to the patient and carry profound professional and medicolegal consequences to physicians and hospitals. The consequence of RSI may be manifested immediately after the operation, months or even years after the operation. A general strategy for preventing RSIs is to account for all items opened or used in a procedure at the end of the procedure because the potential risk for retention cannot always be predicted. Incorporation of appropriate evidence-based standards, documentation and quality improvement measures will improve surgical counting, hence must be adopted in operating room settings. Soft skills of the team members including ethics, accountability, communication and team work cannot be replaced by any measures to achieve best results. Hence, perioperative nurses must have awareness, attitude and proper skill in implementing various techniques and advanced measures to ensure accurate surgical counting. Health care organizations are responsible for drafting and communicating policies and procedures applicable to their practice setting based on the latest recommendations. It is imperative to value teamwork and hold all perioperative personnel accountable for the adoption, implementation, and review of their designated procedures and practices.
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