If you have previously obtained access with your personal account, Retained Surgical Foreign Bodies after Surgery. “We need to ensure that the surgical team does things in the correct order, at the right time and in the right way to ensure that the patient is safe,” Horvath continues. Learn about our remote access options, Hospitals Insurance Company, Inc., New York, NY. Even though none of these techniques individually is likely to completely prevent retained surgical items, when used together the numbers can be reduced. EORNA recommendations on prevention of RSI. Conclusions The correct implementation of the surgical count process by the perioperative nurse may contribute to preventing retained surgical items, thereby improving surgical patient safety. TOP 10 Patient Safety Concerns for Healthcare Organizations, Retained surgical sponges: a descriptive study of 319 occurrences and contributing factors from 2012 to 2017. If you previously purchased this article, Log in to Readcube. Still, the question remains as to why this type of error can happen amongst even the most skilled of surgical teams. “The advantage of bar-coding or radio-frequency is that they allow detection of sponges* before the patient’s surgical wound is being closed, preventing retention,” explains Horvath. The full text of this article hosted at iucr.org is unavailable due to technical difficulties. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, I have read and accept the Wiley Online Library Terms and Conditions of Use. Learn more. However, human errors in the counting process can happen, and especially in the busy operating room environment. “It is the entire surgical team who is responsible for the counting,” adds Horvath. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, © 2020 Association of periOperative Registered Nurses, I have read and accept the Wiley Online Library Terms and Conditions of Use, Access article on Wiley Online Library (HTML view), https://doi.org/10.1016/j.aorn.2016.05.005, join AORN and get access through your member benefits. The updated AORN “Guideline for prevention of retained surgical items” provides guidance for implementing a consistent, multidisciplinary approach to RSI prevention; accounting for surgical items; preventing retention of device fragments; reconciling count discrepancies; and using adjunct technologies to supplement manual count procedures. Retained sponges can cause significant morbidity, and the costs associated with both prevention and treatment of retained surgical items, including legal costs, can … It is also essential... read more, Hygiene in Practice is a service by Lohmann & Rauscher, Preventing retained surgical items: Procedures you can count on. The ECRI Institute’s number 3 concern among their overall “Top 10 Health Technology Hazards for 2019” are retained surgical sponges* 2,3. and you may need to create a new Wiley Online Library account. “A combination of human and clinical factors increases the risk of RSI,” she explains. Other commonly retained items include towels*, parts of instruments or devices and even needles. As the guideline “Challenging or emergency operations, multiple simultaneous or extra-long procedures, unexpected changes in the procedure or productivity pressure are all factors that can drive the attention of the surgical team away from the counting procedure.” It is especially during emergency surgery such as abdominal trauma – when a whole medical team is engaged in treating the patient – that counting instruments might be challenging, and the likelihood of human error increases9. Healthcare organisations need to implement reliable, safe and evidence-based procedures for detecting, analysing and ultimately preventing RSI. Perioperative RNs should review the complete guideline for additional information and for guidance in writing and updating policies and procedures. Retained sponges can cause significant morbidity, and the costs associated with both prevention and treatment of retained surgical items, including legal costs, can be considerable. Prevention of retained surgical sponges: a decision-analytic model predicting relative cost-effectiveness. PREVENTION OF RETAINED SURGICAL ITEMS 1. This review will examine counting, teamwork, radiography, and new technology as methods used to prevent retained surgical items. It is also possible that retained surgical sponges* from the site of the operation to non-sterile bodily tissues, leading to infections, sepsis and sometimes death7. Before, during and after every surgical intervention, a standard practice by an OR team is to count for example instruments and sponges to ensure that nothing has been left behind in a patient. Learn about our remote access options. READCUBE_USER. Most patients who undergo surgery do not realise that there is a concrete risk of leaving the hospital with a foreign object in their bodies. Moreover, the introduction of sponge-detection technologies such as universal X-rays and selective X-rays for high-risk operations, bar-coded sponges, radio-frequency tagged sponges and passive radio-frequency identification tagged sponges could contribute to reducing the incidence of RSI or at least help to identify remaining surgical objects faster. Unlimited viewing of the article PDF and any associated supplements and figures. These items can remain in the body, mostly in the abdomen, for days, months or even years before they are noticed due to inflammatory reactions5,6. They... read more, Not only medical products play a decisive role in safe and hygienically secure operations. If you do not receive an email within 10 minutes, your email address may not be registered, Good teamwork and good communication are also key, especially when procedures are performed under pressure.
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