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Fighting a common never event: retained surgical sponges

Posted by Smiley & Smiley on Nov 4, 2016 12:41:30 PM

As was revealed in last week's post, there has been an effort to reduce the number of never events caused by health care providers in New York and elsewhere. In order to examine the issue in more detail, this week's discussion will focus on a specific never event: retained surgical sponges.

USA Today reveals the extent of the retained surgical sponge dilemma as well as an effective way to battle it. While factors such as geography may dictate the amount of malpractice costs attributed to a lost sponge, the average amount paid out for an incident can total around $150,000. In fact, forgotten sponges are the most prevalent never event problem, as they account for approximately 70 percent of surgical instruments left in patients.

As a preventative strategy, many assert that technology is key. This is due to the unreliability of counting protocols. Certain tracking technologies have been developed to allow providers to better monitor their sponges. For example, each sponge can be assigned a distinct barcode or imbedded with a small radio frequency identification device. In some instances, medical centers have been able to remain completely free of retained surgical sponge events for several years due to the use of these systems.

Still, The Joint Commission suggests additional procedures to supplement the technological approach. This includes regularly documenting instrument counts and inaccuracies, creating training practices that boost open and regular communication during surgeries, and devising standardized counting and prevention strategies. The Commission's recommendations work to address what is seen as the main causes of lost surgical items: miscommunication amongst health care staff members, inadequate education, and intimidation and chain of command issues.

Topics: Medical Malpractice

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