to be placed in the counter bags (10 per bag for Ray-Tec sponges and
5 per bag for lap sponges, with all sponges visible). "We audit our
count process to make sure everyone complies," says Ms. Morrison.
A standard count protocol that your facility sticks to consistently
and that's combined with the occasional audit of the procedures is
essential, says Annesley W. Copeland, MD, FACS, COL, USA (Ret.),
associate professor and core clerkship director in the department of
surgery for the Uniformed Services University of the Health Sciences
in Bethesda, Md. But Dr. Copeland also points to the importance of
clear communication between surgeons and nurses to ensure count
accuracy when you're repeating the count at the prescribed intervals,
such as when you're ready to close a body cavity or before the skin is
closed.
"From the surgeon perspective, I have to alert my scrub tech and
circulating nurse if I put a sponge in a body cavity without immedi-
ately removing it," says Dr. Copeland. "I need to tell them [how
O C T O B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 4 1
tracking technology is meant to avoid relying on the count to
prevent retained items. If your policy covers RF technology for
surgical sponges, simply call it "Preventing Retained Surgical
Sponges," says Dr. Steelman.
• Surgeon-directed. Because you want your policy to cover all
bases, spell out exactly what's expected of your surgeons. "The
policy should require that the surgeon do a methodologic wound
exploration prior to closure," says Dr. Steelman.
• By the book. When it comes to the use of technology, safety
and accuracy should always be top priorities. That of course
means always following the manufacturers' written instructions
for use (IFU).
— Jared Bilski
