Reduce the incidence of retained vaginal gauze during gynecological day surgery

Joint Event on 21^st Global Nursing Education Conference & 4^th International Conference on Holistic Medicine and Nursing Care

March 25-26, 2019 | Orlando, USA

Wei Ya Wen

Kaohsiung Medical University, Republic of China

Posters & Accepted Abstracts: J Nurs Care

Abstract :

Purpose: The retained gauze remains a hazard to patients in major hospitals. Although healthcare providers have paid attention to patient safety and launched an improvement program, the retained gauze events are still hard to completely prevent. According to 2016 Taiwan patient safety report, the incidence of retained foreign body was 3.2%. The possible cause of surgical events were personal factors (81.3%), followed by processor system related (74.2%) and communication factors (59.0%). Therefore, the communication and cooperation between the teams are closely related to patient safety during operation. In 2016, two retained gauze in gynecological patients were found at the postoperative examination at OPD. During the internal examination, the doctor found that the retained gauze in the vagina and caused inflammation and infection of the pelvic cavity. The adverse event caused by human error did not lead to the medical-legal issue but it resulted in injury to the patient. Therefore, the aim of this study was to reduce the incidence of retained gauze by enhancing the staff teamwork, keeping patient safety during operation and improving nursing care quality.

Methods: We reviewed the medical data from January 2016 to January 2017. The incidence of retained vaginal gauze was 2.4% (2/43) after gynecological surgery. Before the project, the correct completion rate of surgery patient safety was 72%. The patient satisfaction to gynecological surgery and health education was only 62.7% and 62.5% respectively. We initiated an improvement project including (a) set up standard operation procedures (SOP) for vaginal gauze placement (b) hold team resource management (TRM) continuous education and health education training (c) design patient safety checklist poster for visual management (d) add pre-operation health education and health education handout (e) produce vaginal gauze ring as nursing innovation (f) put reminder card in the dashboard for surgical instruments (g) give each patient a bracelet as warning label.

Results: (i) The correct completion rate of surgery patient safety was increased from 72% to 100%. The implementation of health education achieved 100% in 42 patients from 7/1~9/30 2017. (ii) The correct rate of vaginal gauze ring placement reached 100% in a total of 25 patients. (iii) The patient satisfaction to gynecological surgery and health education were increased to 97% and 95% respectively.

Conclusion: After implementing the project, we noted that SOP for vaginal gauze placement, a checklist for patient safety, health education for day surgery and nursing innovation could raise the patient safety, increase patient satisfaction and reduce retained foreign body accident.

Biography :

Wei Ya-Wen has completed her bachelor degree at the age of 31 from Tajen University. Currently, she is working as a surgical nurse in the operating room of Kaohsiung City Hsiao- Kang Hospital. She had published more than 3 papers in Taiwan journals and published 5 posters.

E-mail: elline94117@gmail.com