Week 3 Research Problem and Purpose Statements
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Capella University *
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BHA4010
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Medicine
Date
Dec 6, 2023
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docx
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4
Uploaded by EVELOUIS28
Research Problem and Purpose Statements
Eveline Louis
Bachelor of Science in Health Care Administration, Capella University
BHA4010: Introduction to Healthcare Research
Jason Roberts
October 29, 2023
Background and Evidence
Retained foreign object after surgery (FORS) is a serious and preventable hospital-
acquired condition that can cause complications such as morbidity, mortality, and increased
health care costs. The Centers for Medicare and Medicaid Services (CMS) (2023) have identified
14 hospital-acquired conditions for which they do not reimburse, including FORS. The Joint
Commission (2023) defines FORS as a sentinel event that requires immediate and thorough root
cause analysis. Despite preventive measures such as surgical counts, the incidence of FORS
varies from 1 in 32,672 operations in pediatric patients to 1 in 5,027 procedures in general
surgery. The most common types of retained foreign objects are surgical sponges and
instruments. The potential consequences of FORS include “pain, infection, bowel obstruction,
abscess, peritonitis, adhesion, gastrointestinal and urinary tract injury, prolonged hospitalization,
reoperation, and death for the patient, as well as legal and financial implications for the hospital”
(Totonchilar et al., 2023)
Therefore, an effective strategy to prevent FORS and improve patient
safety and quality of care is essential.
One of the potential strategies to prevent FORS is the use of adjunct technology. The
perioperative nurses have to use adjunct technology in order to locate surgical soft products or
verify the outcomes of manual counting operations. (Association of periOperative Registered
Nurses AORN, 2023, as cited in Kyle et al., 2023). AORN (2023, as cited in Kyle et al., (2023)
the evidence-based information to support the development of adjunct technology is by the
"conditional" to "recommendation" in the most recent revision of the "Guideline for prevention
of unintentionally retained surgical items." Applying the instructions can result in a modification
that can assist reduce the risk of damage, as supported by the available data. The device must be
approved by the US Food and Drug Administration. Considering that there is a lack of evidence
on the cost-effectiveness, safety, and acceptability of adjunct technology in preventing FORS.
Moreover, there are potential challenges and barriers to the implementation of adjunct
technology in as a perioperative team member, such as team training, no-interruption zone. In
conjunction with, “avoid performing counts during critical phases of the procedure, such as
during the time out, induction and emergence of general anesthesia, and specimen transfer”
(AORN, 2023, as cited in Kyle et al., 2023).
Problem Statement
The purpose of this study is to investigate, classify, and suggest optimal procedures for
managing and avoiding FORS, a dangerous and avoidable HAC that occurs when a surgical tool
is left within a patient following surgery. One of the top five sentinel events from 2018 to June
2022, FORS has an impact on “patients, surgeons, hospitals, and the medical team” (Kyle et al.,
2023).
Purpose Statement
This mixed-methods study explores FORS, a serious hospital-acquired condition that
occurs when a surgical item is left inside a patient and can cause harm, legal issues, and lower
payments
(Centers for Medicare & Medicaid Services CMS, 2023). The study aims to find out
the frequency, causes, and effects of FORS and suggest the best ways to prevent and handle it, to
improve patient safety, quality of care, and hospital reputation.
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References
Centers for Medicare & Medicaid Services (2023, October 29). Hospital-Acquired Conditions.
https://www.cms.gov/medicare/payment/fee-for-service-providers/hospital-aquired-
conditions-hac/hospital-aquired-conditions.
The Joint Commission (2023, October 29). Sentinel-Event Alert.
https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-
topics/sentinel-event/sea_51_urfos_10_17_13_final.pdf
Totonchilar, S., Aarabi, A., & Hairabedian, A. (2023). The impact of quality improvement
interventions on compliance with standardised surgical count protocol and count
discrepancies: A quality improvement study. Acorn, 36(1), E40-E53.
http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Ftrade-
journals%2Fimpact-quality-improvement-interventions-on%2Fdocview
%2F2827741384%2Fse-2%3Faccountid%3D27965
Kyle, Erin, DNP, RN,C.N.O.R., N.E.A.-B.C. (2023). Preventing Unintentionally Retained
Surgical Items: The Official Voice of Perioperative Nursing. AORN Journal, 117(3), 192-
199. https://doi.org/10.1002/aorn.13885