Sponge Accounting July 2016

SPONGE ACCOUNTING: PREVENTION OF RETAINED SURGICAL ITEMSPolicy #AD-PC 197

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•All sponges–E.g. laps, baby laps, raytex, tonsil sponges, peanuts, cottonoids,

radiopaque towels.

•All sharps–Suture needles, scalpel blades, hypodermic needles.

•Misc –Bovie tips, vessel loops, umbilical tapes, suture booties, or capio.

•All Instruments –On all abdominal & thoracic procedures.

What to Count?

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What to Count?

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Counts will be taken in the following sequence:

1) Surgical site

2) Sterile field

3) Mayo stand

4) Back table

5) Kick buckets

6) Sponge Holders

Count Sequence

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• In Count

• Initial baseline count.

• Cavity Count

• Count performed before closure of cavity within a cavity (e.g. uterus, bladder, stomach, peritoneum.

• Closing Count

• Count performed before fascial wound closure begins.

• Relief Count

• Count performed at time of permanent relief of either surgical tech or circulating nurse.

• Final Count

• Count performed after skin closure, when surgical items are no longer in use and all are passed off the field. THE FINAL COUNT IS A VISUAL OF ALL SPONGES ACCOUNTED FOR in blue backed sponge holders.

When to Count?

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Incorrect & MiscountsWhat to do when your counts are off.

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• An Incorrect Count is a count that does NOT get reconciled.

What is an Incorrect Count? And what do you do?

•Inform your charge nurse and follow your chain of command.

•Repeat Count

•Conduct a thorough search of the room.

–Sterile trash, dirty trash, linens & floors

•Call for x-ray if needed.

•Document count results & actions taken.

–Incident Report

–Incorrect Count Form

–ORM Documentation

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• A Miscount is a form of an incorrect count but the major difference is that a miscount is an incorrect count that gets RECONCILED.

What is an Miscount? And what do you do?

•Inform your charge nurse and follow your chain of command.

•Repeat Count

•Conduct a thorough search of the room.

–Sterile trash, dirty trash, linens & floors.

•Call for x-ray if needed.

•Document count results & actions taken.

–Incident Report

–Miscount Form

–ORM Documentation

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What can we do to Protect the Patient?

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• Learn and follow facility’s Sponge Accounting Policy and Procedures.

• Promptly report any incorrect count.

• Utilize chain of command if necessary.

– Charge Nurse, Manager, Director

• Document accurately and thoroughly.

• Fill out an Incident Report.

• Fill out appropriate forms: Miscount and Incorrect Count forms in Core and Front Desk.

• Document in the ORM appropriately with counts, xrays, and staff involved.

Take Responsibility!

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• CODI/Policy & Procedures

• Posters by Dry Erase Boards

• Resource Staff

• Charge Nurse

• Educator

• Staff Lounge

• Policy on tables

• Morning Meeting Minutes Log

Resources

Thank You