1. Sponge Counting Method Development Group 13: Lanita Adams Advisor: Dr. Raul Guzman

2. 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.

3. Current Sponge Counting Method The scrub nurse and the circulating nurse are responsible for keeping count: 1) When sponges are unpacked 2) Before surgery begins 3)As closure begins 4)During skin closure

4. Complications Abdominal Pain Obstruction Abscess Formation Tumor Hernia Nausea Vomiting

5. 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

6. 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.

7. Design Prototype

8. 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.

10. Total Cost of Device 1) Colored Bags (4) ~ $4.00/pack 2)Bag Holders(3) ~ $5.00 3)Garbage Can(1) ~ $40.00 4)Bag Rings (4) ~ $5 5)Ziplock Bags (4) ~ $3.00/pack

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

12. 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

13. References http://www.google.com/search?q=cache:c9qI8NJk RkoC:www.dns.amedd.army.mil/91d/docs/Ph1_Mat erial/counts.doc+laparotomy+sponge+bags&hl=en http://www.google.com/search?q=cache:c9qI8NJk RkoC:www.dns.amedd.army.mil/91d/docs/Ph1_Mat erial/counts.doc+laparotomy+sponge+bags&hl=en http://www.mslawyer.com/mssc/ctapp/961029/9400 807.html http://www.mslawyer.com/mssc/ctapp/961029/9400 807.html http://www.wisbar.org/Wis4/99-0001.htm http://www.google.com/search?q=cache:AFeClplY MrMC:www.thedoctors.com/rm/sb/tdc_sourcebook _pdf%255Csb5e_4219.pdf+laparotomy+sponge+co unting+&hl=en http://www.google.com/search?q=cache:AFeClplY MrMC:www.thedoctors.com/rm/sb/tdc_sourcebook _pdf%255Csb5e_4219.pdf+laparotomy+sponge+co unting+&hl=en

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