Bar-coding surgical sponges to improve safety: a randomized controlled trial.

Area of Science:

• Surgical Safety
• Medical Technology
• Healthcare Informatics

Background:

• Retained surgical sponges are a rare but preventable complication.
• Existing standardized counting protocols have not eliminated the risk of retained sponges.
• Technological advancements are needed to improve surgical sponge count accuracy.

Purpose of the Study:

• To evaluate a computer-assisted bar-code system for surgical sponge counting.
• To compare the efficacy of a bar-coded sponge system against traditional counting methods.
• To assess surgical staff's perception and tolerance of the bar-code system.

Main Methods:

• A randomized controlled trial involving 300 general surgery operations.
• Comparison of a bar-coded sponge system with traditional manual counting protocols.
• Monitoring of sponge and instrument counts, and recording of discrepancies by observers.
• Postoperative and end-of-study surveys administered to surgeons and operating room staff.

Main Results:

• The bar-code system detected significantly more counting discrepancies (32 vs. 13, P = 0.007).
• Discrepancies included both misplaced and miscounted sponges, with the bar-code system showing higher detection rates for miscounted items (11 vs. 1, P = 0.007).
• The system increased counting time (5.3 vs. 2.4 minutes, P < 0.0001) and introduced minor technical difficulties.

Conclusions:

• Automated counting with bar-coded surgical sponges enhances the detection of miscounted and misplaced sponges.
• The bar-code system was well-tolerated by surgical staff members.
• Despite initial challenges, the system demonstrated potential for improving surgical safety by reducing retained surgical items.