Author Credentials

Amanda Snape, RN

Jed Duff, RN, PhD, FACORN

Oya Gumuskaya, PhD, RN

Kerry Inder, PhD, Grad Dip Clin Epid BN RN

Alison Hutton, PhD


Background: The surgical count process is currently the recommended strategy for preventing unintentionally retained surgical items (RSIs) in Australia. Despite this, RSIs still occur and remain an internationally recognised issue and sentinel event associated with morbidity and mortality. There are numerous new and emerging strategies to prevent inadvertent RSIs, apart from the surgical count, and many involve the use of technology. These strategies are not currently specified in Standards for Perioperative Nursing in Australia (the ACORN Standards).

Aim: To provide an integrative synthesis of the literature to identify current and emerging strategies for preventing RSIs during surgical procedures.

Design: An integrative review process was undertaken.

Method: The literature search was conducted in the CINAHL, ClinicalKey and Medline databases and included primary research papers of any design about RSIs and prevention strategies in humans that were published in English between 2008 and 2022. Data was extracted and developed into a table. Quality assessment was undertaken using the Mixed Method Assessment Tool (MMAT).

Findings: Based on the inclusion and exclusion criteria, 186 articles were screened and 18 studies were included following quality assessment. Data were grouped into categories according to the prevention strategies of surgical count, radiography, radiofrequency technology, barcode technology and other technologies.

Conclusions: RSIs occur despite the mandated use of the surgical count, a human-based process. The use of adjunct, technological prevention strategies is not yet feasible as more research is needed into efficacy and cost-effectiveness.

2022_35(4)3 ESP 1_Strategies-for-preventing-RSIs_Snape_supplemental.pdf (119 kB)
Literature matrix and quality appraisal table

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.