Run Operating Room Instrument Count Audit — Free

Case and Count Documentation

Procedure, room, and date/time documented critical (required)

Record the procedure name, operating room number, date, and audit time.

Circulating nurse and scrub person identified critical (required)

Document the personnel responsible for the count.

Count sheet or electronic count record available at point of use critical (required)

Verify the count record is present and accessible during the audit.

Yes No N/A

Initial count baseline established before closure critical (required)

Confirm the baseline count was completed and documented before wound closure.

Yes No N/A

Initial Closing Count Verification

Sponges counted and reconciled critical (required)

Verify all sponges in use were counted and match the documented baseline.

Yes No N/A

Sharps counted and reconciled critical (required)

Verify needles, blades, and other sharps were counted and match the documented baseline.

Yes No N/A

Instruments counted and reconciled critical (required)

Verify all instruments on the field were counted and match the documented baseline.

Yes No N/A

Count performed audibly and jointly by required staff critical (required)

Confirm the count was performed verbally and verified by both the scrub person and circulating nurse.

Yes No N/A

Any additional items added during the case were documented and counted critical (required)

Verify added items such as sutures, blades, or specialty devices were tracked and included in the count.

Yes No N/A

Final Count Verification

Final sponge count reconciled critical (required)

Confirm the final sponge count matches the expected total.

Yes No N/A

Final sharp count reconciled critical (required)

Confirm the final sharp count matches the expected total.

Yes No N/A

Final instrument count reconciled critical (required)

Confirm the final instrument count matches the expected total.

Yes No N/A

Wound closure and patient exit held until count reconciliation critical (required)

Verify the team did not proceed until the final count was complete and reconciled.

Yes No N/A

Count discrepancy, if any, identified before patient left the room critical (required)

Confirm any discrepancy was detected and escalated before room exit.

Yes No N/A

Discrepancy Resolution

Immediate recount completed by two staff members critical (required)

Verify a full recount was performed promptly by the scrub person and circulating nurse.

Yes No N/A

Field, back table, trash, linen, and floor searched critical (required)

Confirm the search included all likely locations for the missing item.

Yes No N/A

Surgeon notified of discrepancy critical (required)

Verify the surgeon was informed immediately when the count did not reconcile.

Yes No N/A

Resolution documented with item found or variance explained critical (required)

Document where the missing item was found or provide the final variance explanation.

Escalation completed per facility policy if unresolved critical (required)

Confirm escalation to charge nurse, supervisor, or risk management occurred when required.

Yes No N/A

Audit Outcome and Attestation

Audit outcome critical (required)

Select the final audit result.

Note (optional)

Inspector attestation critical (required)

Signature confirming the audit was completed and documented accurately.

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Run: Operating Room Instrument Count Audit

Case and Count Documentation

Initial Closing Count Verification

Final Count Verification

Discrepancy Resolution

Audit Outcome and Attestation

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