2 contact hours
A responsibility of the perioperative registered nurse is to keep all surgical patients free from injury due to extraneous objects, including surgical sponges and towels. While perioperative nurses and other members of the surgical team sign off “the final count is correct” on a daily basis, current evidence consistently identifies incidence of retained surgical items (RSIs) despite reports of a correct sponge count. Retained surgical items continue to have serious clinical, economic, and legal ramifications creating a call to action to rectify practices prone to error. Today, several considerations, including rising malpractice costs, new federal payment penalties, new quality frameworks, patient safety report cards, as well as heightened public awareness, may be leaving health care providers with little choice but to act effectively to prevent the occurrence of RSIs. An overwhelming amount of clinical evidence shows that manual counting of sponges – even when carried out under evidence-based guidelines – often fails due to human error and other factors and therefore is unreliable when used as the primary mechanism to avoid RSIs. Little has changed for perioperative nurses in their “mission critical” job of counting until adjunct technologies became available in 2006.Today, these technologies provide useful tools to supplement the manual counting process to not only achieve accurate counts, but validate them as well, thereby providing the path to zero RSIs. The purpose of this continuing education activity is to provide information that will support all members of the surgical team in providing a safer surgical experience through enhanced awareness of the technologies available to prevent RSIs and validate manual sponge counts. The incidence of RSI and the impact on patient outcomes, including the Sentinel Event Alert issued by The Joint Commission in October 2013, will be discussed. The economic implications, including the impact of federal payment reforms and other initiatives that are part of the Affordable Care Act (ACA) will be explored. The legal ramifications for perioperative personnel will be outlined. The problems associated with manual count procedures, including the impact of incorrect or failed counts, will be described. Finally, the various adjunct technologies available today, with a focus on a system that can document and validate manual counts, will be reviewed.
D0000008667 Rev. AA