RFID Lowdown: Will tagged sponges prevent human error

October 02, 2006

Will tagged sponges prevent human error

Why are RFID tagged sponges making a lot of noise? Statistics indicate that each year an estimated 1500 objects are left inside patients.

“Two-thirds of all objects left in the body cavity are sponges,” according to Alex Macario, MD, of the Stanford University Medical Center. The other reason for concern is that could RFID sponges pave the way for doing away with good nursing practices?

There is also evidence to indicate that items are most likely to be left behind when a patient goes in for an emergency operation, which requires quicker reaction timing and therefore increases the room for error.

Macario's study indicates that it is possible to tag sponges with RFID tags and thereby keep track of them and avoid infection, obstruction or even death. The idea is to improve accountability of each sponge used in the operation theatre.

The tagged sponges are made by Clear Count Medical Systems (Pittsburgh), and also include an RFID reader wand. All that a doctor would have to do is wave his RFID wand over the body and the reader will quickly tell you exactly which type of sponge is not accounted, its batch number and other important details.

Traditionally accounting is done by manually counting the number of sponges. But in an emergency operation theatre, all that counting go very well go out of the window when other issues take priority. To be doubly sure in all high-risk surgeries the patient is usually put through a mandatory x-ray to ensure the patient is clear, regardless of the count outcome.

“Hospitals don’t have a dedicated x-ray machine for counting foreign bodies, and only a radiologist can interpret the image,” says Gautam Gandhi, cofounder of Clear Count. The RFID method is meant to be in lieu of an x-ray and with immediate results.

However, incorporating this into the normal workflow is the problem. “We need a system that is really fail-safe, where, regardless of how people use counting-system technology, the patient doesn’t leave the operating room with a retained foreign body”, says Macario.

The OT personnel need to remember to wave the wand and look for the sponges. That calls for more training and better methods of tracking tagged items in the OT. Now isn't that what the old system of counting lacked? What do you think?

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October 2, 2006 in Tags and Readers | Permalink