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Thank you for your post Cynthia. I have chosen to reply to your post for multiple reasons. Like yourself, I researched this topic whilst undertaking the Advanced Medical Surgical Nursing elective. During my research, I was surprised that I was unable to find Australian studies on the use of sponge tracking technology within Australian hospitals, even though there were 142 instances of retained surgical items requiring re-operation or further surgical procedures between 2012 and 2017 in Australian public hospitals (Productivity Commission, 2019). Furthermore, I chose your topic as this directly applies to my current role as an instrument nurse in an Australian public hospital, and therefore I have a clear understanding of how these errors occur in clinical practice and the need for sponge tracking technology.
 
The first article which addresses your clinical problem is an article by Bardes & Inaba (2017) which looked at the efficacy of radiofrequency identification (RFID) sponge detection technology (Bardes & Inaba, 2017). This technology is designed to assist with in vivo detection of retained sponges, as each sponge is embedded with a radiofrequency transmitter and can be detected during surgical procedures with the use of a sterile detection wand. Bardes & Inaba (2017) found that the RFID detection wand had a 100% sensitivity at detecting missing sponges, even with increasing patient BMI, and that the use of RFID corrected all manual miscount discrepancies, with no retained surgical sponge events occurring during the study (Bardes & Inaba, 2017). The authors concluded that the lack of use of new technology was a contributing factor to the continued rate of retained surgical items, and furthermore, that the expenses associated with using RFID technology was far less than the medical and legal costs associated with retained surgical items (Bardes & Inaba, 2017).
 
The second article which addresses this clinical question is a 2014 article by Williams et al. which also looks at the use of RFID technology (Williams et al., 2014). In this article, the authors demonstrated that the incidence of retained surgical items in five organisations between 2008 and 2016 was reduced by 93% after the introduction of RFID technology, and noted that the remaining incidents of retained surgical items likely occurred because of incorrect use of the RFID detection wand and failure to use the RFID technology in all surgical cases (Williams et al., 2014). The authors concluded that manual counting was not sufficient at preventing retained surgical items and recommended organisations to consider the use of this adjunct technology, particularly as the legal and medical cost of retained surgical items far outweighed the cost of using RFID technology (Williams et al., 2014).
 
The perioperative environment is a highly complex, specialised, and fast-paced area where health professionals must practice at the highest level of care in order to
ensure patient safety (ACORN, 2018). Whilst there are many Australian perioperative nursing guidelines and policies on the management of accountable items during surgery, retained surgical items continues to occur (ACORN, 2018). The articles mentioned have demonstrated that RFID technology can significantly reduce the incidence of retained surgical items, and that organisations should evaluate the introduction of this technology into clinical practice in order to increase patient safety and reduce the incidence of this serious sentinel event.

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