Count all stitches that lie in an inch even if if is just a portion of a stitch on the top side of the quilt. That gives you the number of stitches per inch.
Also in a class I just took the instructor said to get some 'Skin Shield' (it is like a liquid band aid) & put on the finger under the quilt catching the needle. It gives some protection & you can feel the needle sooner than using a band aid or those little plastic discs they sell to protect the finger.