The Need for Accurate Records

Abstract

Dear AfPP

I have recently obtained a senior post in a hospital that is in a different part of the UK in relation to where I have always worked. I have become aware of differing practices, many of which are improving patient care. However, I am concerned that in this perioperative environment, there is no permanent record of items used during each case. The only records of the items used in any one case are those that are recorded on the swab board and the signatures of the staff who undertake the final count in the theatre register. In some of my previous jobs, we have recorded the count on a separate sheet that was then filed in the patients' notes by the scrub practitioner of the case, thus providing a permanent record of the count in the patients' notes. Can AfPP advise on whether a record in the patients' notes is necessary?

Concerned from County Armagh