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October 2010, Volume 40 Number 10 , p 10 - 11


  • Penny Simpson Brooke JD, MS, APRN


I work in a large ED at a teaching hospital. Yesterday a patient was admitted to the ED with abdominal pain. An X-ray revealed a retained surgical sponge pack from a surgical procedure performed at another facility. The patient required a laparotomy to remove the missed pack.What now? Do we contact the other hospital, or leave it to the patient to do that? Should we contact our risk manager? Our facility doesn't seem to have a policy to cover situations like this; should it?—K.R., COLO.Before removing the sponge pack, the physician should have discussed its discovery with the patient as part of the informed consent process. Then the patient, not anyone from your facility, decides whether to take action against the facility or surgical team responsible for the apparent error. Regardless of your facility's policy (or lack of policy) in such situations, it's not your job to discuss the discovery of the sponge pack with the patient or to contact the other facility. However, you should notify your supervisor because risk management will need to be involved.You're also responsible for documenting your nursing care. Discuss the protocol for documenting this situation with your supervisor and ask for clarification on who should notify your hospital's risk management team or administration about the discovery of the sponge pack.Last night on my shift in the ED, I was helping a patient remove his jacket when a small clear packet containing white powder fell out of his pocket. He quickly retrieved it and tucked it away. I suspect the packet contained street drugs. What should I have done? Can I confiscate illegal drugs, or should I call security or the police to handle this?—T.C., IND.No, you can't legally confiscate an item from a patient because you believe it might contain illegal street drugs. The nurse's role doesn't include seizure of patients' possessions, even with a reasonable suspicion that an item isn't legal. If you

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