Research from the United States which explores events related to the surgical count has identified that there are opportunities to review our practice in order to reduce risks to surgical patients. The Safe Surgery Saves Lives Campaign highlights this aspect of perioperative patient safety, ensuring that poor processes and poor communication, often the reasons for retained surgical items, become part of the team ‘sign-out’ at the end of every operation.
‘People working in health care are among the most educated and dedicated workforce in any industry. The problem is not bad people; the problem is that the system needs to be made safer.’ (Kohn at al 1999 p49)
Australian College of Operating Room Nurses2006Counting of accountable items used during surgery Standard 53 In: Standards for Perioperative NursingAdelaide, ACORN
2.
Association of PeriOperative Registered Nurses, 2007Recommended practices for sponge, sharp and instrument counts In: Standards, Recommended Practices and GuidelinesDenver, AORN Inc
3.
Association for Perioperative Practice2007Standards and Recommendations for Safe Perioperative PracticeHarrogate, AfPP
4.
BeyeaS.C.2003Counting Instruments and sponges [Patient Safety First]AORN Journal78290–294
5.
BrennanT.A., LeapeL.L., LairdN.M.2004Incidence of adverse events and negligence in hospitalised patients: results of the Harvard medical practice study 1Quality & Safety in Health Care13145–151
6.
Department of Health2000An Organisation with a MemoryLondon, DH
7.
GawandeA., StuddertD.M., OravJ., TroyenA., BrennanM., ZinnerM.2003Risk factors for retained instruments and sponges after surgeryNew England Journal of Medicine348229–35
8.
GibbsV.C.2005Patient safety practices in the operating rooms: correct site surgery and nothing left behindSurgical Clinics of North America851307–19
9.
Gonzalez-OjedaA., Rodriguez-AlcantarD.A., Arenas-MarquezH.1999Retained foreign bodies following intra-abdominal surgeryHepatogastroenterology46808–12
10.
KaiserC.W., FriedmanS., SpurlingK.P., SlowickT., KaiserH.A.1996The retained surgical spongeAnnals of Surgery22479–84
11.
KohnL., CorriganJ., DonaldsonM eds 1999To Err is Human: Building a Safer Health SystemWashington, DC: Committee on Quality of Health Care in America, Institute of Medicine. National Academy Press
12.
KopkaL., FischerU., GrossA.J., FunkeM., OestmannJ.W., GrabbeE.1996CT of retained surgical sponges (textilomas): pitfalls in detection and evaluationJournal of Computer Assisted Tomography20919–23
13.
LingardL., RegehrG., OrserB.2008Evaluation of a perioperative checklist and team briefing amongst surgeons, nurses, anaesthesiologists to reduce failures in communicationArchives of Surgery (1) 12–17
PonrartanaS., CoakleyF.D., YehB.2008Accuracy of plain abdominal radiographs in the detection of retained surgical needles in the peritoneal cavityAnnals of Surgery247(1) 8–12
16.
WilsonR.M., HarrisonB.T., GibberdR.W.1995The quality in Australian health care studyMedical Journal of Australia163(9) 458–471
17.
World Health Organisation2007a Safe Surgery Saves Lives – background paper draft (unpublished) World Alliance for Patient Safety
18.
World Health Organisation2007b WHO Patient Safety World Alliance for Patient Safety Available from: www.who.int/patientsafety [Accessed: June 2009]
World Health Organisation2008b World Alliance for Patient Safety: Forward ProgrammeGeneva, WHO Available from: www.who.int/patientsafety/information_centre [Accessed June 2009]
