Author(s): Tessy Sebastian, Manju Dhandapani, L Gopichandran, Sivashanmugam Dhandapani


DOI: 10.5958/2349-2996.2020.00080.4   

Address: Tessy Sebastian1, Manju Dhandapani2, L Gopichandran3, Sivashanmugam Dhandapani4
1RN, Hollywood Private Hospital, Perth, Western Australia.
2PhD Nursing, Lecturer, NINE, PGIMER, Chandigarh.
3PhD Nursing, Associate Professor, College of Nursing, All India Institute of Medical Sciences (AIIMS), New Delhi.
4Additional Professor, Neuro Surgery, PGIMER, Chandigarh.
*Corresponding Author

Published In:   Volume - 10,      Issue - 3,     Year - 2020

Peri-operative complications or associated adverse effects are to be prevented and managed using effective management strategies. One of the essential objectives to ensure surgical safety is the prevention of accidental retention of surgical items (RSIs)in surgical wounds. RSIs are rare medical errors that have the potential to cause significant harm to the patient and carry profound professional and medicolegal consequences to physicians and hospitals. The consequence of RSI may be manifested immediately after the operation, months or even years after the operation. A general strategy for preventing RSIs is to account for all items opened or used in a procedure at the end of the procedure because the potential risk for retention cannot always be predicted. Incorporation of appropriate evidence-based standards, documentation and quality improvement measures will improve surgical counting, hence must be adopted in operating room settings. Soft skills of the team members including ethics, accountability, communication and team work cannot be replaced by any measures to achieve best results. Hence, perioperative nurses must have awareness, attitude and proper skill in implementing various techniques and advanced measures to ensure accurate surgical counting. Health care organizations are responsible for drafting and communicating policies and procedures applicable to their practice setting based on the latest recommendations. It is imperative to value teamwork and hold all perioperative personnel accountable for the adoption, implementation, and review of their designated procedures and practices.

Cite this article:
Tessy Sebastian, Manju Dhandapani, L Gopichandran, Sivashanmugam Dhandapani. Retained Surgical Items: A Review on Preventive Strategies. Asian J. Nursing Education and Research. 2020; 10(3): 375-379. doi: 10.5958/2349-2996.2020.00080.4

Tessy Sebastian, Manju Dhandapani, L Gopichandran, Sivashanmugam Dhandapani. Retained Surgical Items: A Review on Preventive Strategies. Asian J. Nursing Education and Research. 2020; 10(3): 375-379. doi: 10.5958/2349-2996.2020.00080.4   Available on:

1. Hempel S, Maggard-Gibbons M, Nguyen DK, et al. Wrong-site surgery, retained surgical items, and surgical fires: a systematic review of surgical never events. 2015; 150(8): 796-805.
2. Dhandapani M, Gupta S, Mohanty M, Gupta SK, Dhandapani SJSni. Trends in cognitive dysfunction following surgery for intracranial tumors. 2016; 7(Suppl 7): S190.
3. Dutta P, Gyurmey T, Bansal R, et al. Visual outcome in 2000 eyes following microscopic transsphenoidal surgery for pituitary adenomas: Protracted blindness should not be a deterrent. 2016; 64(6): 1247.
4. Dhandapani S, Sharma KJSni. Is “en-bloc” excision, an option for select large vascular meningiomas? 2013; 4.
5. Negm HM, Al-Mahfoudh R, Pai M, et al. Reoperative endoscopic endonasal surgery for residual or recurrent pituitary adenomas. 2017; 127(2): 397-408.
6. Dhandapani M, Gupta S, Mohanty M, Gupta SK, Dhandapani SJAon. Prevalence and trends in the neuropsychological burden of patients having intracranial tumors with respect to neurosurgical intervention. 2017; 24(2): 105-10.
7. White S, Spruce LJAj. Perioperative Nursing Leaders Implement Clinical Practice Guidelines Using the Iowa Model of Evidence‐Based Practice. 2015; 102(1): 50-9.
8. Freitas PS, Mendes KDS, Galvão CMJRgde. Surgical count process: evidence for patient safety. 2016; 37(4).
9. Stawicki SP, Moffatt-Bruce SD, Ahmed HM, et al. Retained surgical items: a problem yet to be solved. 2013; 216(1): 15-22.
10. Agrawal V, Gupta P. Gossypiboma due to a retained surgical sponge following abdominal hysterectomy, complicated by intestinal migration and small bowel obstruction-A Case Report. 2018.
11. Zhou Y, Chen P, Qiao T, Chen Y-f, Zong LJM. Complete transmural migration of a retained surgical sponge: an atypical case in image mimicking intussusception: A case report. 2017; 96(42).
12. Rowlands AJAj. Risk factors associated with incorrect surgical counts. 2012; 96(3): 272-84.
13. Feldman DLJMSJoMAJoT, Medicine P. Prevention of retained surgical items. 2011; 78(6): 865-71.
14. Steelman VM, Schaapveld AG, Perkhounkova Y, Storm HE, Mathias MJAj. The hidden costs of reconciling surgical sponge counts. 2015; 102(5): 498-506.
15. Freitas PS, Mendes K, Galvão CMJRgde. Surgical count process: evidence for patient safety. 2017; 37(4): e66877.
16. King CAJAj. Clinical Ethics: Patient and Provider Safety. 2017; 106(6): 548.
17. Chiarella MJAJOJotACoORN. The nurses' responsibility for the swab and instrument count. 1998; 11(1): 39.
18. Wallinvirta EJDtAAUp, Turku. Responsibility as Sounding Board in the Caring’s Context of meaning. 2011.
19. Blomberg AC, Bisholt B, Lindwall LJNo. Responsibility for patient care in perioperative practice. 2018; 5(3): 414-21.
20. Greenberg CC, Regenbogen SE, Lipsitz SR, Diaz-Flores R, Gawande AAJAos. The frequency and significance of discrepancies in the surgical count. 2008; 248(2): 337-41.
21. Rogers A, Jones E, Oleynikov DJSe. Radio frequency identification (RFID) applied to surgical sponges. 2007; 21(7): 1235-7.
22. Riley R, Manias E, Polglase AJBQ, Safety. Governing the surgical count through communication interactions: implications for patient safety. 2006; 15(5): 369-74.
23. Kaiser CW, Friedman S, Spurling KP, Slowick T, Kaiser HAJAos. The retained surgical sponge. 1996; 224(1): 79.
24. Gillespie BM, Chaboyer W, Wallis MJIjons. The influence of personal characteristics on the resilience of operating room nurses: A predictor study. 2009; 46(7): 968-76.
25. Russ S, Rout S, Sevdalis N, Moorthy K, Darzi A, Vincent CJAos. Do safety checklists improve teamwork and communication in the operating room? A systematic review. 2013; 258(6): 856-71.
26. Palmeri JJAj. Developing a comprehensive perioperative nursing documentation form. 1996; 63(1): 239-46.
27. Norton EK, Martin C, Micheli AJJAj. Patients count on it: an initiative to reduce incorrect counts and prevent retained surgical items. 2012; 95(1): 109-21.
28. Agozzino E, Borrelli S, Cancellieri M, Carfora FM, Di Lorenzo T, Attena FJBme. Does written informed consent adequately inform surgical patients? A cross sectional study. 2019; 20(1): 1.
29. Thakur D, Dhandapani M, Ghai S, Mohanty M, Dhandapani SJCjoon. Intracranial Tumors: A Nurse-Led Intervention for Educating and Supporting Patients and Their Caregivers. 2019; 23(3): 315-23.
30. Goldberg JL, Feldman DLJAj. Implementing AORN recommended practices for prevention of retained surgical items. 2012; 95(2): 205-19.
31.    Guidelines for Perioperative Practice: AORN Guidelines. 2017.

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