Guidelines in Practice: Prevention of Unintentionally Retained Surgical Items

Retained surgical items (RSIs) are adverse events that can affect patients, surgeons, and nurses. Interdisciplinary teams should work to standardize surgical item accounting processes and help all perioperative team members prevent RSIs. AORN recently revised the "Guideline for prevention of unintentionally retained surgical items," which provides background information on RSIs and ways to prevent them. The revised guideline describes the role of team communication coupled with specific nursing actions aimed at preventing RSIs. This article reviews key concepts from the guideline and discusses new or changed recommendations regarding a consistent interdisciplinary approach and standard counting procedure; accounting for soft goods, sharps and miscellaneous items, instruments, device fragments and explants, and foam pieces; reconciling count discrepancies; adjunct technology; and education. The article also provides a scenario related to implementing adjunct technology to prevent RSIs. Perioperative leaders and nurses should review the guideline in its entirety and apply the recommendations to prevent RSIs.