Leaving surgical equipment, especially sponges, inside of a patient is called a "never event" in medical circles: it's something that never should happen. However, in an estimated one in 1,500 procedures, it does due to human error. This leads to another surgery for the patient, one not covered by his or her insurance or Medicare, not to mention legal issues...all from an event that never should have happened at all.
Clearcount Medical Solutions has developed a closed-loop system to make sure that it doesn't. The SmartSponge Flex uses radio identification technology to prevent retention of surgical sponges.
The system has three parts: sponges outfitted with an RFID chip like the ones in some credit cards; an ergonomically designed basin (a/k/a the SmartBucket) with scanners and data ports; and a wand to help in the post-surgical accounting process.
Every sponge bears a serial number in the RFID chip. When preparing for surgery, each sponge gets counted in by swiping it over the in-scanner on the side of the SmartBucket. A tone confirms that it's checked in. After use, the sponge is placed in the SmartBucket where another scanner counts it out. No more bar code reading or need for more equipment such as bulky mats, or line of site confirmation to confirm a sponge's whereabouts. The scanner confirms that the chips are working properly. By eliminating the need for physically counting out the sponges, staff exposure to biohazards is reduced as well.
If a sponge is unaccounted for, the wand can be passed over the patient and the surrounding area until a light and tone signal its location. The wand only reads the RFID tags in the sponges so there's no chance of it giving a false positive from an ID badge, for example, or counting the same sponge chip twice. The sponge then gets returned to the basin to reconcile the count. This saves time for OR staff as well as patient exposure, reducing the risk of post-surgical infection. On top of that, there's no need to subject the patient to imaging procedures.
Each operation has a unique case ID number that gives details such as how many sponges were used, length of the operation, and times the wand was used to locate sponges. This data can be seen on a touch screen during surgery as well as downloaded through the ports located at the back of the basin for managerial purposes. No patient identifying data is included.
The SmartSponge Flex System is transportable. The SmartBucket easily rolls from room to room on wheels. It's seamlessly constructed of plastic treated with Microban, preventing the growth of microbes for the life of the unit. Gauze sponges in a wide variety of sizes and surgical towels are available for use with the SmartBucket.
AORN awarded the SmartSponge System its First Seal of Recognition for operating procedures. Other honors include being a finalist in the 2008 International Design Excellence Awards competition sponsored by the Industrial Design Society of America, recognition by Popular Science, and the subject of feature articles in Wired and Time.
Fran Jablway
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Hulet Smith, OT
