Open Forum

If you have clinics that do procedures involving placing sponges/gauze/swabs into a wound or body cavity as part of the procedure (e.g., gyn, cosmetic, wound debridement or other procedures), how do you assure that all the sponges are accounted for (have been removed) at the conclusion of the procedure?  Do you have a sponge count policy for in-clinic procedures?  If a provider performs a procedure alone, does an MA or nurse participate in any sponge count before the patient leaves clinic?  How is it documented?

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Barbara Albertson MN RN AMB-BC
Clinical Nurse Educator
University of Washington Medical Center
Seattle WA
(206)598-6943
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We use a SurgiCount tablet. We use sponges/gauze that have a scanner on them and scan them in prior to the procedure and out after. If they go to another department, like ED or OR, their tablet will tell them how many retained sponges are in the patient. Otherwise they are all counted out. We also have a whiteboard with in/out counts for non sponge items like stitch needles.

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Jennifer Brickley RN
Mayo Clinic
Rochester MN
(507)284-2684
JenniferBrickleybrickley.jennifer@mayo.edu
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Hi Barbara,

We do a lot of procedures in our surgery clinics and even in our dermatology clinic. We adopted the same policy that the operation theatre has. Meaning that a formal count as to be done at the start of the procedure and before the closing. If the surgical procedure does not inclure the creation of a cavity and a count isn't done, the nurse as to justify that the count and re-count is not done in her notes. In my hospital, a nurse is always present for any types of surgical procedures.

We have a document that is the same for the operation theatre and the clinics. A groups is about to start working to adapt that document to better suit the ambulatory care context. Here is the document anyway. My hospital is a french hospital so the document is in french, but you can see the structure of it.

Our nurses also receive a shortened version of the orientation that our operation theatre nurse receive.

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Phebe Gagnon-Courville, M. Sc.
Advanced practice nurse - Transformation of the nursing practice in ambulatory care
Centre Hospitalier de l'Université de Montréal
Montreal, Quebec, Canada
phebe.gagnon-courville.chum@ssss.gouv.qc.ca
1(514)890-8000, 35916
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