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August 16, 2011
From the August 2011 issue of HealthCare Business News magazine

AORN's recently revised “Recommended Practices for Prevention of Retained Surgical Items” also include a new recommendation that perioperative nurses evaluate technology to assist with the surgical count.

The rise of adjunctive technology
This reoccurring issue led to the development of adjunctive technology which aims to eliminate the problem of retained surgical items. The first is a state-of-the art detection system designed to automatically alert OR staff if a surgical item is left behind.

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The latest version of the technology features an automatic detection mat for hands-free patient scanning. The system safely and accurately detects surgical sponges, gauze or towels tagged with a radio-frequency emitting tag, through deep cavity tissue, fluids and bone. With the push of a button, the system can perform a complete scan in approximately 15 seconds, mitigating the risk of a retained sponge, even during emergency situations. Additionally, the system has a dual-detection mode with a wand that is used to perform a quick scan to rectify sponge counts and is useful for extended coverage needs in cardiac, trauma and bariatric cases.

Besides radio-frequency detection, there are other technologies available on the market to prevent RSI. Radio-frequency identification (RFID) systems utilize a large wand to both detect and count surgical materials.

Barcode counting uses uniquely-tagged items which are scanned manually. This system features reporting/performance capabilities and is very portable. However, it is not capable of locating missing surgical items to rectify a miscount or address the risk of a retained surgical item when the count otherwise appears to be accurate.

Sponge counting bags offer hospital staff an easy-to-use, low-cost way to visually account for surgical materials, though also offers no way to locate missing materials and is subject to human error due to its manual nature.

Finally, X-ray may be used in cases where a retained item is suspected, though detection is not guaranteed; it also involves more procedural time and cost.
Retained surgical items are a highly preventable error. As attention to error and patient safety grows with patients/consumers, regulatory bodies and hospitals, health care providers will continue to invest in innovative solutions that mitigate human error. Such technology can improve not only care and patient safety, but also efficiency in the OR, saving time and cost on an ongoing basis.

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