Standardized Count Practices Reduce Retained Surgical Items

Count discrepancies and incorrect counts reduced by 50 percent; estimated $12,500 saved

MONDAY, Jan. 2 (HealthDay News) -- Implementation of quality improvement strategies to standardize count practices can reduce the incidence of unintentional retained surgical items (RSIs) in operating rooms (ORs), according to a study published in the January issue of the AORN Journal.

Elizabeth K. Norton, R.N., from the Children's Hospital Boston, and colleagues conducted a quality improvement initiative in ORs to reduce or eliminate the number of incorrect counts and count discrepancies which lead to unintentional RSIs. They educated perioperative staff, standardized count practices, reviewed every reported count discrepancy with the nursing team, collaborated with the radiology department, and reviewed and revised the hospital's count policy. Observational audits were conducted to improve compliance with the initiative. Audit results were shared with the nursing staff, and the audit tool was revised when thresholds were met.

The investigators found that the initiatives reduced both the number of count discrepancies and the number of incorrect counts by 50 percent between 2009 and 2010. An estimated $12,500 were saved, as the need for intraoperative radiographs for unresolved counts decreased.

"These initiatives, with the adoption of adjunct technology, will optimize the goal of preventing RSIs. Retained surgical items are preventable 'never events,' and perioperative nurses play a vital role in ensuring that 'never' becomes reality," the authors write.

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