Outpatient Surgery Magazine

Special Edition: Staff & Patient Safety - October 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 19 of 43

Dr. Marsh agrees: "Staff members have to use it correctly. They can't take shortcuts. Sometimes everybody's rushing, and they're trying to get to the next case, and the barcode count may be forgotten or not done. Then the patient is out of the room and they realize, 'We don't have all our sponges.'" Does the counting technology extend surgical or turnover times? The advocates we spoke to it does- n't. "This is all done during the case," notes Dr. Cima. "When we begin to close the patient, the nursing team is already counting sponges. We have not been able to attribute counting of the sponges using the technology to any increases in the duration of the case. "If you drop this technology into the OR without setting the stage and working it into the standard workflow, it's not going to work," he continues. "This is an adjunct to reinforce with our staff the appropriateness of their manual process." Counts still matter Proponents of sponge counting and detection sys- tems stress they're not meant to be replacements for manual counts, but rather to provide confirma- tion and reassurance that the manual count was correct. "You perform the surgery, and prior to close, you count, and then you wand the patient, because counts can be incorrect," says Ms. Langerman, who reports the wand can find sponges at least 18 inches deep. How often does the wand find a sponge? "The percentage of retained objects is very low," she says. "We haven't found anything within a patient. However, if I've done a final count and I can't find a sponge and know it's not in the patient, I've wanded trash looking for sponges." Dr. Marsh agrees her institution's barcode- based system isn't a replacement for manual counts. "We made it a tool," she explains. "The process is the same, except now it's computer technology that's recording the information. The reason we need the technology is because we're human, and we make mistakes." In addition to peace of mind, however, the technology also provides a record that goes beyond paper charting. Dr. Marsh says this can be crucial in a case where, for example, a surgery took place at your facility and then a sponge is retained when the patient undergoes another procedure somewhere else. "If they come back to us and say, 'You left the sponge from the original surgery,' we can pull that case's record and say, 'No, we closed our count out before the patient left the room,'" she says. "All we had before was our paper chart that said, 'We counted together, and the count was correct.'" Dr. Cima notes another attractive byproduct of the technology: It removes a frequent bone of con- tention. "The biggest issue has always been when the nurse says the sponge count is off, and the sur- geon says, 'Well, it's your responsibility, count again,'" he says. Now the nurse says, 'The machine says we're off by one,' and once they say that, the surgeon's got to look for the sponge." OSM 2 0 • S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 2 0 RARE BUT DEVASTATING These 2018 images show how a woman suffering for years from abdominal bloating had two retained sponges from a prior surgery.

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