also shown that having a high body mass index increases the risk.
An error in counting can also occur when nurses are exhausted, when
the operation is an emergency or when there are unforeseen changes
during surgery. Warn staff to be extra cautious in these instances.
• Embrace technology. There are several technologies designed to
increase accuracy of the count. One option uses barcoded sponges or
towels embedded with a tiny radiofrequency tag. At the end of sur-
gery, but before the incision is closed, staff can use a scanner to
detect any sponges or towels left behind. The surgical items can
either have a unique identifying number or not. If the radiofrequency
tags do not have unique identifying numbers, the wand is waved after
every case to find any items left behind. In the case above, this could
have been helpful to find the lost towel left inside the woman, even
though they had the correct count. Radiofrequency tagging with
unique identifying numbers lets staff more easily count the individual
items as they're removed. An antenna connected to computer soft-
ware detects and counts each unique item. If a discrepancy occurs
between the initial and final counts, the OR team is alerted and uses a
detection wand to find the lost item.
OSM
8 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 6
Ms. Harlan (cami@cpw-law.com) is an attorney with Crandall, Pera & Wilt
who specializes in medical malpractice cases. She became a registered nurse in
1981 and has worked in a variety of hospital settings, including in the ICU,
emergency department and as an administrative officer.
