How are surgical instrument counts typically conducted, and by whom?

• A. Final counts are performed by the scrub technologist and circulating nurse before incision and before wound closure, with any discrepancies resolved before proceeding.
• B. The surgeon alone counts instruments at the end.
• C. The nurse in the recovery room handles instrument counts after surgery.
• D. Counts are not necessary if there is a checklist.

Answer: (A)

Counting instruments and materials during a procedure is a safety check to prevent a retained item. It is done collaboratively by the sterile team member (scrub technologist) and the circulating nurse, at two critical times: before the incision and before wound closure. They verify the counts of instruments, sponges, and needles, and any discrepancy triggers a pause to recount and resolve it before the surgeon proceeds. This teamwork-based approach reduces the risk of leaving items inside the patient, something a recovery-room nurse or postoperative checklist alone cannot reliably prevent, and it goes beyond a single person counting. Therefore, the practice is final counts performed by the scrub technologist and circulating nurse before incision and before wound closure, with any discrepancies resolved before proceeding.