Colo. Human error is inevitable, she points out, even during the seem-
ingly basic task of counting sponges.
That's why her eight-hospital health system invested in radio-fre-
quency identification (RFID) sponge detection systems. Proprietary
sponges are embedded with RFID tags, which are detected by the sys-
tem's underbody mat and a wand that staff pass over patients. At the
conclusion of a case, the circulator activates the detection mat, which
scans the patient for tagged sponges left behind. According to the
health system's policy, circulating nurses must also use the wand to
check for sponges in patients with a BMI of 51 or greater. Ms. Hedrick
points out the wand can also be used to scan the outside of trash cans
in the OR in search of missing sponges if the manual count is off.
Technology should augment, not replace, the manual count, says
Valerie Marsh, DNP, RN, CNOR, perioperative education specialist
supervisor at the University of Michigan Health System in Ann Arbor.
Nurses and surgical techs at her hospital use a barcode ID system to
help confirm the accuracy of manual counts. They open a package of
five sponges and use the system's touchscreen tablet to scan barcodes
on each sponge to digitally document the "count in." The system cap-
tures which staff member did the scanning, the patient who is under-
going surgery and the number of sponges placed inside the patient.
To keep track of removed sponges, staff hang a counter bag on an
IV pole, so its five clear pouches — matching the number of sponges
in each pack — are easily visible to members of the surgical team. As
sponges are removed from the patient, they're rescanned into the bar-
code system, which records and displays the "count out."
Staff load scanned sponges into the counting bag's pouches, starting
from the bottom up. When a bag's five pouches are full, a scrub tech
rolls it up and places it in the corner of the OR, where it's available for
reference if the final count is off. The tech continues to hang and fill
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