2.50
Hdl Handle:
http://hdl.handle.net/10755/162013
Category:
Abstract
Type:
Presentation
Title:
When IT Counts
Author(s):
Cass, Carole; Swift, Lystra M.; Keating Ash, Ann V.; Chung, Yvonne; Guzman, Janet E.; Lafferty, Fidelma; Layton, Laura A.; Nikolaj-Weeks, Mira
Author Details:
Carole Cass, MSN, RN, CNOR, Memorial Sloan Kettering Cancer Center, New York, New York, USA, email: cassc@MSKCC.ORG; Lystra M. Swift, MSN, RN, CNOR; Ann V. Keating Ash, MSN, RN; Yvonne Chung, ST; Janet E. Guzman, RN; Fidelma Lafferty, RN; Laura A. Layton, BSN, RN, CNOR; Mira Nikolaj-Weeks, RN
Abstract:
Poster presented at AORN's 58th Annual Congress: Retained Foreign Objects (RFO) increase patient morbidity and mortality, as well as hospital cost. Despite safeguards such as counting protocols, RFO still remain a risk. An estimated 1,500 cases of RFO occur annually in the US. To promote patient safety, Memorial Sloan Kettering has implemented new guidelines to prevent the occurrence of a retained foreign body. In 2009, 19,233 procedures were performed in MSKCCs Operating Rooms. Like other ORs, MSKCC is vulnerable to RFO. We have experienced our share of RFO and near-miss events. To ensure patient safety, the following interventions have been implemented: Revision of count policy, including count times, and items counted; revision of Count Sheet Elements added and deleted; add area for documentation of closing instruments; update process for incorrect count; revision of x-ray requirements for sponges and needles; reinforcement of CPD count sheet use; decrease the number of instruments on trays; adoption of Red Zone; no staff change during counts; Handoff Key points are reviewed; staff change not permitted during critical moments; role determination; roles refined for two circulators; surgeon participation; perform a purposeful search of the wound; communicate sponges placed in wound; clear count; implemented count and detection technology; debriefing; and implemented process QA monitoring. The combined strategy of increased communication, mechanical intervention, and monitoring has helped in accomplishing and maintaining our goal. We have been incident free for 382 days.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2011
Conference Name:
AORN 58th Annual Congress
Conference Host:
Association of periOperative Registered Nurses
Conference Location:
Philadelphia, Pennsylvania, USA
Description:
AORN 58th Annual Congress, 2011 held March 18, 2011 - March 24, 2011 in Philadelphia Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleWhen IT Countsen_GB
dc.contributor.authorCass, Caroleen_US
dc.contributor.authorSwift, Lystra M.en_US
dc.contributor.authorKeating Ash, Ann V.en_US
dc.contributor.authorChung, Yvonneen_US
dc.contributor.authorGuzman, Janet E.en_US
dc.contributor.authorLafferty, Fidelmaen_US
dc.contributor.authorLayton, Laura A.en_US
dc.contributor.authorNikolaj-Weeks, Miraen_US
dc.author.detailsCarole Cass, MSN, RN, CNOR, Memorial Sloan Kettering Cancer Center, New York, New York, USA, email: cassc@MSKCC.ORG; Lystra M. Swift, MSN, RN, CNOR; Ann V. Keating Ash, MSN, RN; Yvonne Chung, ST; Janet E. Guzman, RN; Fidelma Lafferty, RN; Laura A. Layton, BSN, RN, CNOR; Mira Nikolaj-Weeks, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/162013-
dc.description.abstractPoster presented at AORN's 58th Annual Congress: Retained Foreign Objects (RFO) increase patient morbidity and mortality, as well as hospital cost. Despite safeguards such as counting protocols, RFO still remain a risk. An estimated 1,500 cases of RFO occur annually in the US. To promote patient safety, Memorial Sloan Kettering has implemented new guidelines to prevent the occurrence of a retained foreign body. In 2009, 19,233 procedures were performed in MSKCCs Operating Rooms. Like other ORs, MSKCC is vulnerable to RFO. We have experienced our share of RFO and near-miss events. To ensure patient safety, the following interventions have been implemented: Revision of count policy, including count times, and items counted; revision of Count Sheet Elements added and deleted; add area for documentation of closing instruments; update process for incorrect count; revision of x-ray requirements for sponges and needles; reinforcement of CPD count sheet use; decrease the number of instruments on trays; adoption of Red Zone; no staff change during counts; Handoff Key points are reviewed; staff change not permitted during critical moments; role determination; roles refined for two circulators; surgeon participation; perform a purposeful search of the wound; communicate sponges placed in wound; clear count; implemented count and detection technology; debriefing; and implemented process QA monitoring. The combined strategy of increased communication, mechanical intervention, and monitoring has helped in accomplishing and maintaining our goal. We have been incident free for 382 days.en_GB
dc.date.available2011-10-27T08:44:17Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T08:44:17Z-
dc.conference.date2011en_US
dc.conference.nameAORN 58th Annual Congressen_US
dc.conference.hostAssociation of periOperative Registered Nursesen_US
dc.conference.locationPhiladelphia, Pennsylvania, USAen_US
dc.descriptionAORN 58th Annual Congress, 2011 held March 18, 2011 - March 24, 2011 in Philadelphia Convention Centeren_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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