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Hospitals
use different methods of accounting for equipment used during surgery. Surgical
sponges are cloth pads that are used in surgeries to absorb bodily fluids
during surgery. Different hospitals use different methods to account for the
sponges that are placed in the body to make sure that all of the sponges are
removed prior to concluding the surgery. That responsibility belongs to the
medical facility where the procedure is being performed and its employees, and the
attending nurses. The key to making
sure no surgical instruments are left behind in the patient body is to keep a
count of what surgical items are used and where each one ends up.The
common practice to account for sponges is counting how many sponges are present
before the case starts, count many sponges are being placed inside the body and
count how many they have remaining after the procedure is over.

Another
way of accounting for lost sponges is to use a sponge with radio-opaque
material and take an x-ray after the case is over to ensure that there are no
sponges left within the body. Stryker is a company that manufacture sponges with
a barcode embeds inside making it easier to
keep track of how many sponges are being used and whether any have been left
behind. In this case none of these methods was
exercised correctly.Most errors in healthcare are due to
human factors.”It’s like aviation -if you don’t do these checks, there can
be human errors that happen. That’s why we put these standard practices in
place. You follow the same process every single time, because then you can say,
‘we never, ever vary from this practice.'(Damages from left-behind surgical tools top billions as systems seek end
to gruesome errors. (n.d.). In this case of the forgotten sponge it can
be argued that the nurse assisting with the surgical procedure at Bella
Hospital did not follow proper accounting method to account for the
lost sponge.

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            What
happen when a surgical sponge is left in the body? A retained surgical sponge
is known as gossypiboma, it can cause pain, infection, abscess, intestinal
obstruction or fistula. They can
be life threatening and usually results in further surgeries and treatments. Studies estimate that a lost surgical
sponge happens once in every 5,500 to 7,000 surgeries; there were 51.4
million in-patient procedures performed in 2010, according to the
National Center for Health Statistics (Bernstein 2014).Leaving a surgical instrument in a patient’s body may be
surgical malpractice that can result in serious harm to a patient. We now
know that retention has very little to do with patient characteristics and
everything to do with operating room culture (Indianapolis
Retained Surgical Instruments Lawyers. (n.d.). Retained surgical items are medical errors that have the
potential to cause significant harm to the patient and carry major consequences
to physicians and hospitals.

The potential for a lawsuit is always present when the public
relies on any organization for care. The health care professionals are very
familiar with the claims of liability and must prepare for the moments when
things go wrong and plan for the worst case scenarios. The law states that any
organization that the public relies on for its safety has a duty to exercise
ordinary care to prevent injury (Dunn 2016).  Liability
is always imposed on the organization resulting in patient injuries and
negligent care. Medical professionals have a duty to meet a recognized standard
of care. When they fail to live up to their duty, patients and their families
have a right to seek monetary damages.

Negligence
is the action or non-action that results in injury by an individual who is not
acting as a reasonable prudent person would under the same circumstances (Dunn2016).The hospital has the legal duty to
provide each patient with reasonable safe condition, trained and skilled
staffs, adequate equipment and to administer proper medication. If they fail to
fulfil those duties to the patient they could be found negligent. The nurse did
not follow the organization police and procedures thus leading to injury to the
patient. In this case of the
forgotten sponge the nurse can be held liable and a claim
of negligence against the hospital due to her action. In terms of this nurse the institution is
not only responsible for its action in relations the patient but it is also
indirectly liable for the patient injuries caused by its employee.

Hospitals
can be held liable for their own negligence, and they can also be held liable
for the negligence of
their employees. When a patient injuries and caused by a hospital
employee, the hospital may be held liable
under the legal doctrine of respondeat superior. Under respondeat superior the institution (employer) is
legally responsible for the negligent or wrongful act or omission of the
employee even though the facility itself committed no wrong (Dunn2016).
The hospital is liable because they have the right to control the action of the
employees that includes the manner of how work is performed, duties and method.
Bella Hospital is responsible due the nurse committing a negligent act because the nurse was acting within the scope
and course of employment and acting on behalf of the institution. In
2007, the Centers for Medicare and Medicaid
Services estimated the
average price of removing one of these items at $63,631 per hospital stay, and
larger settlements in lawsuits can run from $2 million to $5 million (Bernstein 2014). Because of the post-surgical retained items
are so preventable, the National Quality Forum has listed retained surgical
items as a completely preventable error that should never happen.

As a manager I can view this as an
opportunity for improvement on policies and procedures by implementing new ways
to account for equipment used during surgery. We must implement a standardize way of counting which is done every time, for
every patient, in every procedure, and also how well those counts are
documented and tracked. Those
counts could be made accurate by using a wand that would detect the radiofrequency that is stored inside of the sponges,
supplementing the manual counting procedures. This would eliminate human error when counting. The management
mandate team
meetings as a standard part of the surgical procedure to allow any team member
to express concerns they have with the patient care, how well they follow implemented
polices and any unsafe act in the operating room. As a manager we have to be
familiar with every aspect of our jobs that could result in legal issues. We
have to be compliant with the have polices and procedure that we have in place and
report deficiencies as they pop up.  

Retained
surgical instruments in patients should never happen. With that being said any surgical
procedure is susceptible to human error. In the case of a retained sponge
proper counting/accounting procedure was not followed by the surgical staff. Their
error could lead to a claim of negligence, malpractice against the hospital. New
Technology can ensure that patients won’t be sewn up with a sponge left inside
of them. Even with the emergent of such technology many hospitals and surgical centers have failed
to adopt the readily available technologies that could eliminate the risk of
leaving sponges in patients. Retained-sponge
prevention technology should be a standard protocol on every surgical procedure.
Hospital will continue to have lawsuits following the
discovery of foreign objects within patients if they don’t adopt preventive
protocols and carefully follow them.

 

 

 

 

 

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