Lorie A Hassel-Chuang, BSN, RN: No financial relationships to disclose
Learning Outcome: To educate the Perioperative community on a new sponge counting system that both lowers the risk of cross-contamination and increases the accuracy of sponges counts through improved visibility of used sponges.
Overview/Abstract: To provide data demonstrating how current sponge counting systems in the market today pose higher risks of cross-contamination and lack the visibility to enable an accurate count of used sponges. Recent findings from contamination and ergonomics studies will be presented which will highlight the limitations of traditional sponge boxes and bags that will reinforce the need for a solution that can reduce colony-forming unit (CFU) levels. The session will provide data collected on how the new disinfectable design can significantly reduce CFU levels and comply with infection prevention standards versus current systems. The session will also demonstrate how the telescopic sponge counter will provide visibility to the sponges that will streamline the counting process, thereby saving time and increase the accuracy of sponge counts. We will go over how the core features of the telescopic sponge accounting system will support a comprehensive strategy to move towards zero harm in perioperative care. A cost-benefit analysis will be provided on the time savings for staff (including increased staff satisfaction) while reducing the risks and liability related to retained surgical items.
Description of Current State: Countable sponges are still the top retained surgical item (RSI) left in patients. AORN guidelines show there is a need for a multifaceted approach to reduce the chances of an RSI even. Current sponge management tools elevates the risk of microbial exposure and CFUs due to high and moderate touch points. Moreover, current systems do not provide the visibility needed for the accurate accounting needed to reduce RSIs in moderate sponge use procedures. Currently, seven prototypes of the newly designed telescopic sponge accounting systems are being tested within the University of Kansas Health Care Systems. Data is being collected and the results show improvement at reducing cross-contamination and CFUs over current commercially available sponge boxes and bags. Moreover, staff feedback has been positive in terms of ergonomics, time savings and overall staff satisfaction on its ease of use.
Utilizing a sponge counter that can reduce the time of OR time, by reducing the chance of miscounts is a must and needs to be studied at a larger scale. Cost of nosocomial infections can be costly Cost of RSIs are costly.
Description of Desired/Achievable State: To partner with a medical device manufacturing company to produce a product that can be commercially available to other hospitals and health care systems. Additionally continue having broader discussions of processes related to counts in the OR.
Audience Engagement: Explain methods you will use to Engage and Re-engage the Audience during this activity, i.e. pre-test, post-test, polling questions, small group activity, sharing experiences, Question & Answer period, et al.
Conduct sharing experiences of contamination and RSI events that have compromised patient safety and poll participants on what process improvements and tools are needed in order to reduce those risks. Present the new design and solicit the audience for suggestions of any improvement and changes they would like to see from both a safety and ease of use standpoint. Have participants simulate the loading of used sponges to check the maneuverability of the telescopic system and the ease of counting.
Additional Information:
Content/Topics: I. Introduction Overview of the session objectives Importance of accurate sponge counts and infection prevention Brief introduction to the telescopic sponge counter concept II. Current Challenges in Sponge Counting Overview of traditional sponge counting systems (boxes and bags) Inclusion and Exclusion data on contamination study Limitations in visibility and counting, leading to risk of RSI III. Evidence from Recent Studies Summary of contamination study findings Ergonomics data highlighting workflow inefficiencies Reinforcement of the need for a disinfectable, visible solution IV. Innovation Spotlight: Telescopic Sponge Counter Key features of the new design Enhanced visibility Disinfectable materials Streamlined counting process Comparison with current market options V. Infection Prevention Impact Discussion of how a new box/bags design will reduce CFUs Compliance with infection prevention standards Implications for patient and staff safety VI. Operational and Financial Benefits Time savings for OR staff Increased staff satisfaction Cost-benefit analysis: reduced risk of RSIs and liability VII. Strategic Alignment How the innovation supports a zero harm strategy in perioperative care Broader implications for OR safety culture VIII. Conclusion and Discussion Recap of key takeaways Open Q&A and audience engagement Practical steps for implementation in attendees’ own ORs
References: 1. Staff A. Standardizing Sponge Accounting: A process that works - association of. Aorn.org. November 4, 2022. Accessed May 12, 2025. https://www.aorn.org/article/2019-10-09-Standardizing-Sponge-Accounting. 2. Carmack A, Valleru J, Randall K, Baka D, Angarano J, Fogel R. A multicenter collaborative effort to reduce preventable patient harm due to retained surgical items. The Joint Commission Journal on Quality and Patient Safety. 2023;49(1):3-13. doi:10.1016/j.jcjq.2022.09.005 3. Romano PS, Gibbs VC. Retained Surgical Items: Definition and epidemiology. Retained surgical items: Definition and epidemiology. January 4, 2024. Accessed April 12, 2025. https://psnet.ahrq.gov/primer/retained-surgical-items-definition-and-epidemiology. 4. Sikora A. Nosocomial infections. StatPearls [Internet]. April 27, 2023. Accessed June 1, 2025. https://www.ncbi.nlm.nih.gov/books/NBK559312/. 5. 1. DJ; KHWM. Perioperative bacterial contamination from patients on contact precaution in operating room environment. Open forum infectious diseases. Accessed June 1, 2025. https://pubmed.ncbi.nlm.nih.gov/33244480/.
