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Retained surgical item prevention — USMLE Step 3 MCQ

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HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeRetained surgical item preventionUSMLE Step 3

A surgical service has repeated retained-sponge near misses. Counts vary among teams and discrepancies are resolved informally. Which intervention is best?

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Correct answer: B — Standardize counts and document reconciliation before closing the wound

Standardized counts with reconciliation and independent checks address the process defect before closure. Near-miss reporting is essential learning data; memory and delayed detection are weak controls.

Reference: AHRQ, Patient Safety Primer: Medication Errors: https://psnet.ahrq.gov/primer/medication-errors