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Retained Surgical Items

I would highly recommend this module if your facility's goal is to promote patient safety in the operating room. Considering the high-risk of possible retained items during surgery, I believe it would be appropriate to use on an annual basis for all team-members within the surgery department. 

– Carol Reams, RN, CNOR


This module provides guidance to perioperative registered nurses (RNs) in preventing retained surgical items (RSIs) in patients undergoing surgical and other invasive procedures. Counts for soft goods, sharps, and instruments are performed to account for all items used on the surgical field and to lessen the potential for injury to the patient as a result of an RSI. Health care organizations are responsible for employing standardized, transparent, verifiable, reliable practices to account for all surgical items used during a procedure to lessen the potential for patient harm as a result of retention.

There is a potential for inaccurate counts with both current variable manual counting practices and the use of adjunct technology. Therefore, behavioral change and an understanding of risk reduction strategies unique to each setting should be employed when adopting system(s) to account for all surgical items. A reliable system to account for all surgical items includes, but is not limited to, complete and accurate counting, radiological confirmation, and the use of adjunct technology, to promote optimal perioperative patient outcomes.


The goal of this activity is present reliable practices implemented by all perioperative team members to reduce the occurrence of retained surgical items.


  • Discuss reliable practices implemented by all perioperative team members to reduce the occurrence of RSIs.

  • Identify reconciliation methods to reduce count discrepancies throughout the surgical procedure.

  • Discuss the role of adjunct technologies when performing surgical counts.

Course Requirements

To receive 1.8 contact hours for this module, you must achieve mastery of the content and submit an evaluation as instructed at the end of the course. This module contains 58 questions.

Contact Hours

The 1.8 contact hours for this course will expire September 30, 2015.


AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

AORN is Provider approved by the California Board of Registered Nursing, Provider Number CEP 13019.


This program is approved for 1.8 hours of AEU credit by BASC provider #0102.


AORN recognizes these activities as continuing education for registered nurses. This recognition does not imply that AORN or the American Nurses Credentialing Center approves or endorses products mentioned in the activity.

Guidelines for Perioperative Practice


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