lost sponges and the legal costs — consider the long and expensive
legal battle TriStar Centennial Hospital is facing — involved when
RSIs cause patient harm.
The human element
While technology has a role in preventing RSIs, it must be used appro-
priately as an adjunct to manual counting, says Ms. Cerese. "There
was a time when experts thought technology would solve the retained
item issue," she adds. "But it's also about dedication and diligence to
established [manual counting] processes."
Research has shown that items are more likely to be left behind in
patients when there is a lack of communication among surgical team
members and disorganized work patterns in the OR. That's why Ms.
Cerese believes everybody in the OR must know exactly what proto-
cols are to be followed and follow them consistently and implicitly
(see "No Sponges Left Behind").
Amber Wood, RN, MSN, CNOR, CIC, FAPIC, senior perioperative
practice specialist at AORN and author of the AORN Guideline for
Prevention of Retained Surgical Items, is also a big believer in
accountability and teamwork. "You need to minimize the silos within
the team by training everyone together whenever possible," says Ms.
Wood.
That makes sense. Even the slightest variations in counting proto-
cols can cause objects to be left behind. When everyone is being
trained together on your facility's counting method, variations in prac-
tice are far less likely to occur.
When training your surgical team on how to account for objects
used during surgery, make the practice sessions as realistic as possi-
ble. That will get them used to the process and help you identify what
works — and what doesn't.
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