NoThing Left Behind-Surgical Patient Safety
The issue of foreign objects, and most specifically sponges, being left behind in surgical cases is a serious issue. Harrison is committed to ensuring our staff provide exceptional healthcare that is of the highest quality. In 2010, Harrison adopted a strategy called NoThing Left Behind, a national surgical patient safety effort to prevent retained surgical items left in patients. It is led by San Francisco professor and MD, Verna C. Gibbs, MD.

NoThing Left Behind provides a three-level approach to accounting for surgical objects. Its premise understands that, like in this case, human factors such as counting errors lead to items, like sponges, being left behind. Nationally, in 80% of retained sponge cases, the count of items was correct. The retained sponge was not thought left behind.

The efforts include a three-step-approach to counting surgical field sponges.

  • Step 1: Is for the Operating Room (OR) to only use xray detectable sponges or towels and for the technician and nurse to perform a sponge count to confirm numbers of sponges being used in surgical procedures.
  • Step 2: Is a simple practice where nurses will use hanging sponge holders and a white board in each OR in a standardized process to count the types and numbers of surgical sponges being removed as the surgery concludes.
  • Step 3: Is for surgeons to perform a methodical wound exam in every case and verify with the nurses that all the sponges are out. A final step occurs only if the sponge count is still incorrect. In this last step, xray-detecting wands are used to determine whether the missing sponges were retained in the patient.

Those efforts paid off. In 2011, Harrison had no items, including sponges, being unaccounted for at the end of the surgery.

As was reported in this Kitsap Sun article, "It's difficult when mistakes happen, but sometimes mistakes do happen." Harrison's efforts are to give our staff members the tools and training to specifically reduce the likelihood of that happening. We will continue to work with our media partners to help educate and inform both reporters and the community. We ask your continued help in doing so with those who ask you questions about Harrison and our quality initiatives.