Interventions for the Prevention of Retained Surgical Items: A Systematic Review

Abstract

Background Retained surgical items (RSI) are preventable error events. Interest in reducing RSI is increasing globally because of increasing demand for safe surgery. While research of interventions to prevent RSI have been reported, no rigorous analysis of the type and effectiveness of interventions exists. This systematic review examines (1) what types of intervention have been implemented to prevent RSI; and (2) what is the effectiveness of those interventions.Methods We performed a systematic review of PubMed, Embase, CINAHL, Cochrane Library, Scopus, Clini-calTrials.gov, Mednar, and OpenGrey databases. Two reviewers independently screened a total of 1,792 titles and abstracts, and reviewed 87 full-text articles, resulting in 17 articles in the final analysis. Study characteristics included qualitative and quantitative studies that examined the effectiveness of RSI prevention interventions for adult patients who undergo open surgery. The primary outcome was RSI and related error events. Results Four studies and 13 quality improvement projects described RSI interventions categorized into four groups:(1) technology-based, (2) communication-based, (3) practice-or guideline-based, (4) interventions that fell into more than one category. Following guidance in the Quality Improvement minimum quality criteria set, the quality of all studies ranged from poor to fair. Heterogeneity in the interventions used and variable study quality limit our confidence in the interventions' ability to reduce RSI. Conclusion Since technology-based interventions may not be financially feasible in low and middle-income countries (LMIC), in those settings interventions that target the social system may be more appropriate. Rigorous methods to investigate local contexts and build knowledge are needed so that interventions to prevent RSI have a greater likelihood of success.

Minimization of occurrence of retained surgical items using machine learning and deep learning techniques: a review

“…Additionally, these incidents expose healthcare providers to legal investigations and cast uncertainties on the standing of medical institutions [4]. Enhancing patient safety and diminishing the legal and reputational perils that healthcare practitioners and organizations encounter make the prevention of RSIs a pivotal concern in contemporary healthcare [5]. The healthcare sector is making strides toward significantly reducing RSI occurrences, augmenting patient well-being and healthcare standards.…”