Oops!
Radiofrequency ID (RFID) chips, similar to those implanted in products to deter theft, may help prevent sponges and other materials from being left in a patient during surgery, the findings from a small study suggest.
Still, further research is needed to determine whether placement of these chips in surgical sponges and other operating room materials will be cost effective for a problem that occurs once in every 10,000 procedures.
At most hospitals, the operating room staff counts the number of sponges before the operation starts and then counts them again at the conclusion to make sure none are been left inside the patient. Still, according to lead author Dr. Alex Macario, counting strategies are not perfect.
Gee. That’s a surprise.
The present study, which is reported in the Archives of Surgery, involved eight patients who underwent abdominal or pelvic surgery. RFID-tagged or untagged sponges were placed by one surgeon and then a second surgeon, who did not know the sponge type, ran a wand over the patient’s abdomen to look for the sponges.
“When we started, I was concerned about the technological part of the problem,” Dr. Macario noted, “but our study found the device works 100 percent of the time. The real challenge is how you incorporate a new device into the workflow of the operating room. We need a system that is really fail-safe — where, regardless, of how people use a counting system technology, the patient doesn’t leave the operating room with a retained foreign body.”
Since the existing system doesn’t work, doesn’t that suggest getting the new method into gear? And maybe we need RFID tags on everything entering the operating room?
If it’s economical at this time, then go for it.
If it’s not, then hospitals will have to increase their rates A LOT. That’ll in turn increase the HMO’s, and the lot, to increase their prices. All of which will cause people (hmmm…who do we know that complains about things like high insurance rates, medical treatments, etc…?) to complain even more.
Wait until some twit doctor leaves the scanning wand inside a patient.
From experience working in a hospital, this IS NOT a way to invest in technology to improve on patient care.
If this happens at all it is a MAJOR MALFUNCTION and not something to fix with RFID. It would be better to invest in XRAY LUMINANT, or ULTRASOUND LUMINENT embedded paints/dies in these possibly left over devices.
It’s easier to make a chip that can survive an autoclave than a coating of pigment of any kind. (Not to mention that there isn’t a problem now finding this stuff with an X-ray; it’s when the patient is on the table about to be sewn up when the ID tech is needed.)
You don’t have to autoclave these chips, they could be processed with EtO gas, which is used to sterilize heat sensitive devices.
If they can make a chip that will withstand the autoclave’s temperature and pressures then it sounds like a great idea. The clamp shown in the X-Ray shouldn’t be a problem to detect using metal detection. A sponge on the other hand would be relatively invisible in an X-Ray.
My wife, an RN, has a colleague who found an old sponge in a patient. They Doctors saw a large growth in his abdomen and believed it to be cancer. After further tests and exploratory surgery, they discovered the sponge from an operation 15 years ago. It had grown its own blood supply and tissue mass. It will not be an easy operation to remove it without serious risk to the patient.
Then about a year ago, a woman failed to pass the metal detector at an airport. It turned out she had some forceps from an operation just six weeks earlier.
Based on a Seinfeld episode I saw, they should also attach RFID tags to Junior Mints from hospital vending machines.
It’s a serious problem that merits inclusion 😉
To add a strange, if not entirely on track, story…As a nursing student about a hundred years ago, I was observing an obnoxious surgeon perform surgery. At the end, while the nurses were starting to count sponges and clamps, etc. he quietly walked behind them to a window and put a clamp behind a curtain on the windowsill. Then walked out.
The nurses were beginning to panic when I told them what he had done.
His prior truely awful behavior during surgery, and that as the last straw, killed the choice of surgical nurse as a career for me. He may or may not have been a good surgeon, but he was a nasty, mean person. Later experience taught me that while great skill and great bedside manner don’t always go together, great egoes and mouths frequently (more than chance) seem to walk hand in hand with stupid errors, scapegoating, and an increased rate of infection and rehospitalization. jh
Here’s an idea:
Keeping an inventory of everything that was used and accounting for it prior to closing up the patient.
Nothing substitutes best practices and procedures, even technology…
#9 Yes. jh