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Great ideas for your OR
Don't Just Count Sponges, Account for Them
A simple and inexpensive system to prevent retained objects.
M
anually counting
the sponges a surgeon uses in a procedure is highly unreliable.
In recent years, electronic
SPONGE ACCOUNTING
tracking systems that use
Throughout surgery, the
circulating nurse places
bar-coded or radiofrequenused sponges in the easily
visible hanging holders, each
containing 10 pockets. At the
cy-tag-equipped sponges
end of the procedure, each
pocket should contain a
(tinyurl.com/o5vtn3l) have
sponge, whether used or not.
made it easier to verify
counts and prevent retained objects, yet not every OR employs them.
Could accounting for sponges, not just counting them, be the answer?
Sponge ACCOUNTing — the letters are capitalized for emphasis on
accountability and accounting — is a system that involves hanging
plastic blue-backed sponge holders and a wall-mounted dry-erase
board to record the surgical counts in a standardized manner so everyone can see how sponges are being used. The process is centered on
the question: "Where are the sponges?" rather than "What's the count?"
Sponge ACCOUNTing requires that OR staff manage all sponges in
multiples of 10. Throughout surgery, the circulating nurse places used
sponges in easily visible hanging sponge holders, each containing 10
pockets. The blue-backed sponge holders hang on racks attached to
designated IV poles. You use a separate holder for each sponge type.
"At the end of the operation, you must have 1 sponge in each of the
pockets of the sponge holder, whether they are used or unused," says
surgeon Verna C. Gibbs, MD, director of NoThing Left Behind, an
independent national surgical patient safety project trying to prevent
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2013
