RESOURCES FOR MANAGING HOSPITAL-ACQUIRED CONDITIONS

Good to Know

Important fact(s) about the condition being discussed in this issue…

Retained foreign objects in patients have resulted in major injuries such as sepsis, bowel perforation, and death.

Surgeons informed at the time of closure that a sponge or instrument is missing must stop and do a sweep. A surgical sweep is defined as, "visual and manual interrogation of the cavity which has been operated on." A surgeon's most common reaction or response to an incorrect count has been, "It's not in there." Sometimes, it is. A second count should be done while the surgeon is doing the sweep. If the count is incorrect again an X-ray must be taken. The radiologist needs to be informed of the item in question, the operative site, and the other pertinent information such as additional drains and lines that may affect the X-ray reading.

A new technology in which sponges are embedded with radio frequency identification chips supports, and may someday replace, manual counting of surgical sponges. With this technology, a wand is waved over the patient by the surgical nurse to detect if any sponges remain (Wahlberg, 2007; Ohio State, 2008).