bags until each sponge
has been removed
from the patient, res-
canned and counted.
The barcode ID sys-
tem must be closed out, meaning all the sponges that were scanned
into the system before the procedure were scanned back in after they
were used, before the patient can leave the OR.
It's a multistep process that might seem like overkill, but Ms. Marsh
views it as a patient safety double-check. "It took a while for nurses
and techs to make the method part of their routines, but now it's sec-
ond nature," she says. "The technology works, but we didn't feel com-
fortable relying on it alone. That's why we still require staff to com-
plete a manual count."
No excuse
Sponges are sometimes found five or six years after they were left
behind in patients, who often endure years of dealing with abscesses
and abdominal pain. Retained sponges will eventually be found, even
years later, and tracked back to the OR where it went missing.
Ms. Marsh says many retained object errors occur because physi-
cians don't perform an all-stop and pause to check the abdomen
before closing. Some nurses claim they don't have enough time to
make accurate counts after surgery. Try selling that excuse to a
patient or lawyer. Retained objects are indefensible. They simply
shouldn't happen.
"If you follow a standardized policy, which should include manual
counting and technological assistance, you're not going to have a prob-
lem," says Ms. Marsh. "At our hospital, a sponge left in the patient is
considered a sentinel event, even if it's identified and removed before
1 0 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 2 0
The technology works, but we didn't
feel comfortable relying on it alone.
Valerie Marsh, DNP, RN, CNOR
