California Health & Safety Code 1279.1 requires reporting of adverse events to the California Department of Health, no later than five (5) days after the event was detected, or if that event is an ongoing urgent or emergent threat to the welfare, health, or safety of patients, personnel, or visitors, not later than 24 hours after the adverse event has been detected.
An Adverse Event does include:
(1)(D) Retention of a foreign object in a patient after surgery or other procedure, excluding objects intentionally implanted as part of a planned intervention and objects present prior to surgery that are intentionally retained.
AORN Recommendation II: Sharps and other miscellaneous items should be counted on all procedures.
- Sharps and miscellaneous items (eg, vessel clip bars, vessel loops, umbilical and hernia tapes, vascular inserts, cautery scratch pads, trocar sealing caps) should be counted:
- Before the procedure to establish a baseline,
- Before closure of a cavity within a cavity,
- Before wound closure begins,
- At skin closure or end of procedure, and
- At the time of permanent relief of the scrub person and/or circulating nurse (although direct visualization of all items may not be possible).
- Initial sharps counts should be performed and recorded for all procedures. Performing counts constitutes a primary and proactive injury prevention strategy. Counting sharps and miscellaneous items is not only important in preventing foreign body retention; the continuous accounting for these items can lessen injuries to those scrubbed in the sterile field.
- Sharps and miscellaneous items should be counted audibly and viewed concurrently by two individuals, one of whom should be a registered nurse circulator. Concurrent verification of counts by two individuals lessens the risk for count discrepancies.
- Sharps counts should be conducted in the same sequence each time as defined by the facility. This assists in achieving accuracy, efficiency, and continuity among perioperative team members. Studies in human error have shown that all errors involve some kind of deviation from routine practice.
- Members of the surgical team should account for sharps or other miscellaneous items that may have been broken or become separated within the confines of the surgical site in their entirety. Breakage and/or separation of parts can occur during open as well as minimally invasive surgical procedures. Verification that all broken parts are present or accounted for helps to prevent the unintentional retention of a foreign body within the patient.
About the Author
Attorney Steven Peck has been practicing law since 1981. A former successful business owner, Mr. Peck initially focused his legal career on business law. Within the first three years, after some colleagues and friend’s parents endured nursing home neglect and elder abuse, he continued his education to begin practicing elder law and nursing home abuse law.