SurgiCount System Eliminates Risk of Retained Surgical Sponges Interview with: Stryker
Nate Miersma
Director of Surgical Safety

Editor’s note: As part of an ongoing series on health care safety, Nate Miersma discusses the use of Stryker’s SurgiCount system to reduce he incidence of retained surgical sponges.

Nate Miersma Director of Surgical Safety Stryker Corp

Nate Miersma What is the background of the Stryker Surgicount Safety-Sponge System? 

Mr. Miersma: Retained surgical sponges are the number one reported surgical never event, occurring roughly a dozen times per day in the United States. SurgiCount helps hospitals eliminate retained sponges by supplementing and verifying the manual count of sponges using a unique bar code for each sponge.

• The traditional manual sponge-counting method expects nurses and surgical technicians to track sponges with extreme precision using only a whiteboard and dry-erase marker. Though the majority of nurses and surgical technicians are experienced and thorough, the fast-paced, high-pressure environment of an operating room creates the risk for false-correct counts caused by distraction, exhaustion or personnel changes. At a rate of 11 times per day, the ‘white board while multi-tasking’ method clearly isn’t sufficient.

• When using SurgiCount, a nurse or surgical technician scans the barcodes to enter them into the computer’s backup count. During the closing count at the end of the procedure, a nurse or surgical technician scans each bar code again, while the computer tracks which sponges have been counted out and which remain. If the counts do not match, the SurgiCount scanner identifies which sponge or sponges are still unaccounted for, and directs staff to resolve the count by locating the outstanding sponge or sponges. Numerous clinical studies indicate that the primary cause of retained surgical sponges is false-correct counts. SurgiCount ensures that these false-correct counts no longer occur during the busy closing process.

• The scanner never gets tired or distracted, and can’t accidentally count the same sponge out twice, or count out a sponge which was accidentally introduced to the case possibly from another room, or from a sponge which was hidden and left over from a previous case. How big is the problem of retained surgical sponges? What are the medical and financial costs of a retained sponge?

Mr. Miersma: The medical cost of a retained sponge could have serious implications on a patient. Patients with retained sponges first experience the fear and uncertainty of mysterious pain and other symptoms. Once diagnosed, they face more surgery and more time in the hospital, along with the associated risks of infection and the delay in healing. More than 16 percent of patients who experience a retained surgical item sustain a permanent injury, and 4.5 percent of patients die as a result.

• In regards to the financial costs of a retained sponge, the average malpractice impact for a retained surgical item, including corrective surgery, indemnity payments and legal costs, is $600,000. The system-wide cost of retained surgical items contributes $94.50 to the cost of each and every surgery in the United States. How does the Stryker system reduce the likelihood of a retained sponge? Is it cost-effective? Easy to implement?

Mr. Miersma: By tracking each sponge with a unique bar code, Stryker SurgiCount is able to account for every sponge that is used, notifying staff if a false-correct count has occurred.

• More than 8,700 SurgiCount scanners are currently installed in more than 480 healthcare facilities across the United States. More than 180 million SurgiCount sponges have been used in more than 10 million procedures over the past five years, and the system has never failed to identify a retained sponge.

• Compared with the estimated $600,000 in malpractice risk associated with a retained surgical item ($94.50 per procedure), the $8 to $10 cost per procedure to implement SurgiCount represents a significant cost saving. Based on the expected occurrence of a retained sponge (1 in 5,500 surgeries) and the average cost ($600,000 per incident), the use of SurgiCount in 13 million procedures over the past five years has prevented thousands of retained sponges and saved more than $1.4 billion. Is there anything else you would like to add?

Mr. Miersma: To really solve the problem of retained surgical sponges, we have to address the real root issue, which is false-correct counts. Known mismatching manual counts are not the problem — if the count out at the end of a procedure does not match the count in during the procedure, the team knows to look for a missing sponge. The real problem is a false-correct count in which the counts match but are not accurate. In such cases, the surgical team doesn’t know to look for a retained sponge. In fact, 88 percent of cases involving a retained surgical item have a matching, or false-correct, count. SurgiCount addresses this root problem directly by verifying the manual count and alerting the surgical team if any sponges are unaccounted for. Thank you for your contribution to the community.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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