Department

Unintended Retention of a Foreign Object

of
Nursing Joshua Jones BSN Candidate BYU-Idaho

Hypothesis Significance of the Theory Implications

• After this research study, nurses will know
Using blue surgical sponges in the Problem Maslow’s Hierarchy of Needs whether using blue surgical sponges rather than
• According to the National Practitioner Data white surgical sponges will or will not lower the
place of white surgical sponges will Bank, 4,857 malpractice payouts occurred • Needs are divided into 5 tiers: overall number of unintended retention of a
from 1990-2010 in the United States. physiological, safety and security, love and
lower the number of cases of belonging, self-esteem, self-actualization.
foreign object cases.
• Retained foreign object cases result in more • This research study supports Maslow’s hierarchy
unintentional retention of foreign time in the hospital for patients. • For needs of a higher tier to be met, lower of needs theory. By seeking to eliminate cases of
objects. • The longer the item is retained, the more tier needs must have already been met. unintended retention of a foreign object, this
serious the health complications. research study may increase patient safety,
• Retained foreign objects link to the safety thereby meeting the needs of the safety tier in
tier. Maslow’s theory.
Methods • If using blue surgical sponges instead of white
surgical sponges reduces cases of unintended
• This is quantitative quasi experimental retention of foreign objects, then nurses will use
research. blue surgical sponges in surgeries rather than
white.
• The research population is a minimum of
100,000 surgical patients. Recommendations
• Participating hospitals will report the total Retrieved from https://upload.wikimedia.org/wikipedia/commons/c/c3/Maslow%27s_hierarchy_of_needs.png

number of retained surgical items from the • It is recommended that a future qualitative
year before the intervention and the year that Annotated Bibliography study be performed to increase research on
the intervention is applied. These numbers • Freitas, P. S., Silveira, R. P., Clark, A. M., & Galvao, C. M. (2016). this subject.
Surgical count process for prevention of retained surgical items: An
will be compared to see the effect of the integrative review. Journal of Clinical Nursing, 25(13), 1835-1847. It is
intervention on unintended retention of an integrated review which seeks to evaluate the use of the surgical
• It is recommended that this research be
foreign object cases. count process in preventing unintended retention of foreign objects. This applied to hospitals worldwide.
Retrieved from http://images.wisegeek.com/surgical-sponge-with-surgical-scissors.jpg
research suggested that numbering the surgical sponges can be helpful
for surgical staff because if one is missing, the number should help staff • It is also recommended that some changes be
recognize when that specific sponge was used.
• Nisar, M. U., Ali, K., Nisar, M., Latif, H., & Sikander, S. (2017).
made in the experimental design of this
Problem Gossypiboma: A case report.) Pakistan Journal of Surgery, 33(2), 155-
157. This is a qualitative case study. Surgical teams could use this
research. The use of a control group along
with an experimental group may help to
Unintended retention of a foreign object cases research to help identify possible causes of unintended retention of a
foreign objects in the operating room setting, which could lead to better ensure greater accuracy in a future
continue to occur and can result in increased patient care. experiment.
cost to the healthcare system, increased time in • Sengupta, A., Hadjiiski, L., Chan, H., Cha, K., Chronis, N., & Marentis,
treatment, and serious health complications for T. C. (2017). Computer-aided detection of retained surgical needles from

patients.
postoperative radiographs. Medical Physics, 44(1), 180-191. This study
is quasi experimental quantitative research, where images were collected
from cadavers that either contained or didn’t contain a surgical needle.
References
• 1 in 6,975 surgeries resulted in a retained This research study shows that a computer system was able to recognize
retained surgical needles from CET scans 75% of time. • Feldman, D. L. (2011). Prevention of retained surgical items. Mount Sinai Journal of Medicine, 78(6), 865-871.
foreign object. • Williams, T. L., Tung, D. K., Steelman, V. M., Chang, P. K., & Szekendi, doi:10.1002/msj.20299

• 1 in 1,000 abdominal surgeries results in a M. K. (2014). Retained surgical sponges: Findings from incident reports • Mehtsun, W. T., Ibrahim, A. M., Diener-West, M., Pronovost, P. J., & Makary, M. A. (2012). Surgical never events in

and a cost-benefit analysis of radiofrequency technology. Journal of the the united states. Surgery, 153, 465-472. https://doi.org/10.1016/j.surg.2012.10.005
retained foreign object. American College of Surgeons, 219(3), 354-364. This research • Özsoy, Z., Okan, I., Daldal, E., Dasıran, M. F., Angın, Y. S., & Şahin, M. (2015). Laparoscopic removal of

• Surgical sponges are the most commonly contained a cost-benefit analysis on the use of radiofrequency
technology to detect retained surgical sponges during surgery. The
gossypiboma. Case Reports in Surgery, 2015, 1-4. doi:10.1155/2015/317240

retained item. results showed that the use of radiofrequency technology decreased • Stawicki, S. P., Moffatt-Bruce, S. D., Ahmed, H. M., Anderson, H. L., Balija, T. M., Bernescu, I., ... Cook, C. H.
Retrieved from http://www.hindawi.com/journals/cris/2012/263841.fig.002.jpg
cases of unintended retention of a foreign object by 93% which (2013). Retained surgical items: A problem yet to be solved. Journal of the American College of Surgeons, 216(1),

decreased costs to medical staff and hospitals. 15-22. https://doi:10.1016/j.jamcollsurg.2012.08.026