Preventing Retained Surgical Items

It’s A Team Expedition 


Beverly K. Walker, MA, RN, CNOR

Renae N. Battié, MN, RN, CNOR- Franciscan Health System

Explore the challenge of preventing retained surgical items (RSIs) from the perspective of an expedition- comparing the OR team to an expedition team comprised of various members with a variety of levels of skill and experience. In a mountain climbing expedition, risk is always present, no matter how skilled the climbers are. Using data from climbing disasters, and by pulling comparisons from one author's analysis of adventures gone wrong, we begin to see how the goal of reaching the summit (the surgical procedure) is just half of the success equation. Often teams lose focus once they reach the apex, losing site of the fact that the descent is often a risky part of the climb. A contrast is made between the old model (counting as a task between RN and tech) and the new model of joint and shared accountability of everyone on the team to insure nothing is left behind. Specifying roles, calling out non-negotiables, and describing what a culture of safety looks like, all with the backdrop of a mountain adventure and the diligence toward detail, is what keeps everyone safe.


  • Discuss the risk potential in a surgical procedure for retained surgical items (RSIs). 
  • Discuss the evolution of perioperative team member roles regarding the accounting for surgical items in the wound. 
  • Compare predictable elements of a mountain expedition event with those of an RSI event. 

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