Featured Image

Count Us Out!  Preferred Placement and Packaging of Surgical Instrument Count Sheets

by Ryan Weiers

Some Central Sterile Processing Departments have placed instrument count sheets inside wrapped sets and ridged sterilization containers for a long time, so why should we consider moving count sheets outside of surgical sets? Why bother with the change?  It’s easier to put them inside, right?

Let’s think about this from the patient’s perspective. Where would YOU prefer count sheets be placed if YOU were the patient, or SOMEONE YOU LOVE was the patient? Would you want that paper count sheet and ink leaning up against instruments that go inside your body?  Do you know where the paper and ink have been?  You know they haven’t been cleaned, right?

Weigh the pros and cons and decide for yourself. Where SHOULD your department place count sheets? 

Count Sheets Inside


  1. It’s easy and we’ve always done it that way
  2. Count sheet won’t get lost inside
  3. Count sheets need to be sterile*

* They actually don’t. Check out this excellent resource from IAHCSMM (see Objective 4) https://www.iahcsmm.org/images/Lesson_Plans/CIS_Plans/CIS250.pdf 


  1. No validation or IFU’s for paper or ink. If it goes in the set it needs both.
  2. Ink damage on instruments and containers. It doesn’t come off.
  3. Shredded paper fibers can cause foreign body reactions in patients.

Count Sheets Outside


  1. Non validated items remain outside of the sterile environment, always
  2. You can verify set contents without opening, therefore instruments remains sterile
  3. Reduced infection risk to patients


  1. Extra step in central sterile processing, albeit a very small one
  2. Added cost if using additional external packaging (pennies)
  3. New process and change can be challenging *

* but it doesn’t have to be http://www.ghscorp.net/products/count-me-out


The decision is pretty clear to us. You can COUNT US OUT!

Making the change to outside is easier than ever: http://www.ghscorp.net/products/count-me-out


call Have questions, feedback, or ready to order? Contact Us Here »
Or call us at (800) 548-1004