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MHA s Safe Count Call to Action

What's the Big Deal. In the past year, 64% of Retained Foreign Objects reported under the MN Adverse Health Care Event Reporting Law were retained sponges in Vaginal DeliveriesRetained sponges in vaginal deliveries are now included in the Joint Commission's list of reportable sentinel events . Wh

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MHA s Safe Count Call to Action

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    2. MHA’s Safe Count Call to Action Sponges and Sharps used during Vaginal Deliveries will be counted prior to use and accounted for after delivery

    3. What’s the Big Deal In the past year, 64% of Retained Foreign Objects reported under the MN Adverse Health Care Event Reporting Law were retained sponges in Vaginal Deliveries Retained sponges in vaginal deliveries are now included in the Joint Commission’s list of reportable sentinel events

    4. What about the Patient Retained sponge can cause: Abdominal pain Fever Abscess Formation Episiotomy Breakdown Subsequent recto-vaginal fistula 50% resulted in lawsuit

    5. The Sponge Count Only radiopaque sponges will be used after delivery. When used, place in new basin on table Wipes will be provided for pericare before delivery The initial count can be performed by 2 trained OB staff: MD, RN, LPN or CAN Count out loud while both people are paying attention Stop and start over if distracted Counted items will be logged on Kardex by RN

    6. Suture/Injection Needles Needles placed on the delivery table will be logged on the Kardex by nursing The MD will place needles in a Needle count box on delivery table after use. Needles will be counted at the end of delivery as part of the Final Count and disposed in the dirty utility room by OB Staff

    7. Fetal Scalp Electrodes FSE’s will also be accounted for Please let the nurse know if you have removed one. Story: FSE attached to Cervix—to C/S– found at 6 week follow-up appt.

    8. Pause for the Gauze Post delivery/repair, the MD is to call for a Final Count OB RN to count with MD: Sponges and Needles and verify against Kardex log The RN will name the 2 people who verified the count in the OB Delivery Assessment along with any interventions required

    9. Count Discrepancy Inspect delivery field, the room and warmer MD to examine the genital tract If count is still incorrect, x-ray to be done

    10. Special Considerations Count Discrepancy—Pelvic x-ray No initial baseline count—Pelvic x-ray If item intentionally left in place, communicate to OR if applicable and mark on Kardex—confirm removal when occurs. RN to document on Delivery Assessment; If Not confirmed as removed—x-ray

    11. Safety is our Goal July 1, 2008

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