Sponge Counting Method Development

Group 13: Lanita AdamsAdvisor: Dr. Raul Guzman

Background•Doctors and other hospital staff are sometimes unable to detect sponges inside the patient and may also miscount the number of sponges. As a result, the sponges are left inside of the patients body. This condition is called Gossypiboma.

•From 1985 to 1998, the incidence of objects being left in patients has occurred at a steady rate of more than 40 per year. 601 of those cases have involved hospitals, surgical clinics, and TDC-insured physicians. Most of the incidents involve the 4x4 laparotomy sponges.

Current Sponge Counting Method

The scrub nurse and the circulating nurse are responsible for keeping count:

1) When sponges are unpacked2) Before surgery begins3)As closure begins4)During skin closure

Complications

•Abdominal Pain•Obstruction•Abscess Formation•Tumor •Hernia•Nausea•Vomiting

Mechanism Causing the Problem

•Team Fatigue•Difficult Operation•Sponges sticking together•Hurried/Poor Counting System•Teams may have fewer counts because a delay may be fatal for the patient

Goal

Create a device that will keep an accurate count of the surgical sponges to prevent them from being left inside the patient’s body.

Design Prototype

Statistics•The main types of sponges used during surgeries are 4x4, 4x8, 12x12, and 18x18.

•The number of sponges used during surgeries range from 4 to 100.

• The number of operations per year is ~29,328,000.

Sponge Dimensions

$0.21 – 0.27

$210 - 270

100 Pcs/bag

10 bags/case

18" x 18“: 4 ply

$0.10 – 0.20

$100 - 200

100 Pcs/bag

10 bags/case

12" x 12“: 4 ply

$5.6 - 7.85

$56 - 79

200 Pcs/bag

10 bags/case

4" x 8“: 8, 12 ply

$3.25 - 5.56

$33- 56

200 Pcs/bag

10-20 bags/case

Sponges, 4" x 4“: 8, 12,16 ply

As Low AsUnitProduct Description

Total Cost of Device

1) Colored Bags (4) ~ $4.00/pack

2) Bag Holders(3) ~ $5.003) Garbage Can(1) ~ $40.004) Bag Rings (4) ~ $55) Ziplock Bags (4) ~ $3.00/pack

Benefits

•Sanitary•Can save the hospital more than $500,000 in lawsuits•Easy to use•Accurate•Reasonable•Cost benefit ratio:

Proof of Improvement• Provides a method for keeping all sponges together and accurately accounted for•Speeds up counting process•Colored-coded bags make it easy to distinguish different-sized sponges•Reduces chance of leaving sponges inside of patients

References•http://www.google.com/search?q=cache:c9qI8NJkRkoC:www.dns.amedd.army.mil/91d/docs/Ph1_Material/counts.doc+laparotomy+sponge+bags&hl=

en

•http://www.mslawyer.com/mssc/ctapp/961029/9400807.

html

•http://www.wisbar.org/Wis4/99-0001.htm

•http://www.google.com/search?q=cache:AFeClplYMrMC:www.thedoctors.com/rm/sb/tdc_sourcebook_pdf%255Csb5e_4219.pdf+laparotomy+sponge+counting+&hl=

en

•http://www.google.com/search?q=cache:XSRynCBRuzwC:www.dns.amedd.army.mil/91d/docs/Ph1_Material/blood_calc.doc+weighing+sponges+&hl=en

http://www.google.com/search?hl=en&q=lawsuit+verdicts+for+retained+sponges