Inclusion criteria were events meeting Joint Commission definitions of URFO and sentinel event. The study—“Unintentionally retained foreign objects: A descriptive study of 308 sentinel events and contributing factors,” by Victoria M. Steelman, PhD, RN, CNOR, FAAN, and coauthors—examined sentinel events reported to The Joint Commission involving URFOs (excluding sponges used intraoperatively and guide wires) between October 2012 and March 2018.7 The retained objects were as follows:7 1.
Unintentionally retained foreign objects (URFOs) remain the sentinel events most frequently reported to The Joint Commission. Retained surgical items (RSIs)*—also known as unintended retained foreign objects or retained foreign bodies—can cause emotional and severe physical harm such as infection, loss of function, and even death.1Nationally, items left behind include sponges, sharps and needles, instruments, small miscellaneous items, devices, and device fragments.2 The categorical classification of “foreign object unintentionally retained after surgery” may include swallowed pennies, pins, shrapnel, bullets and other objects while surgical items are the tools and materials that we use in procedures to heal not to harm¹. Elite Medical Experts hand selects leading university experts for litigation and complex consulting. Surgical procedures take place within a system of perioperative care composed of surgeons, perioperative registered nurses, surgical technologists, and anesthesia professionals. Therefore the ACS recommends the following guidelines that can be adapted to various practice settings, including traditional operating rooms (OR), ambulatory surgery centers, surgeons’ offices, and other areas where operative and invasive procedures are performed: The ACS also endorses the National Quality Forum’s definition of “end of surgery” as the moment “…after all incisions or procedural access routes have been closed in their entirety, device(s) such as probes or instruments have been removed, and, if relevant, final surgical counts confirming accuracy of counts and resolving any discrepancies have concluded and the patient has been taken from the operating/procedure room,” where applicable. Unintentionally retained foreign objects (URFOs) remain the sentinel events most frequently reported to The Joint Commission. A total of 1,156 contributing factors were identified, most frequently in the categories human factors, leadership, and communication. Such specialists can speak to the appropriate standards of care and treatment of surgical patients and whether the hospital had appropriate policies and procedures to minimize incidents of Retained Foreign Bodies.
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