The importance of effectively managing swabs

Every day thousands of operations are carried out using thousands upon thousands of swabs. As the number of swabs used in operating theatres continues to rise, due to the increased service demand, the need to effectively address the issue of retained items is more pertinent than ever. With NHS budgets under increasing pressure, healthcare providers can't afford to not have a watertight policy in place.

A duty of care to patients and healthcare colleagues is vital at every level and for every operation. The swabs used in each surgical procedure pose a potential threat not only to the patient but also to the staff handling them. The possible risks are many and varied. For patients, retained swabs can result in negative outcomes, including further surgery, prolonged hospital stays, distress and extended time off work. There is also the risk of infection and, ultimately, death. For healthcare staff, those acting as circulators in theatre are potentially at risk from cross infection due to unnecessary handling of dirty swabs. This could put them in danger of HIV, Hepatitis A, B and C, MRSA, Streptococcus and Staphylococcus, along with other bacterial infections.

When a swab is unintentionally left inside a patient's body, this type of patient safety event is referred to as a 'Never Event'. A Never Event is an event NHS England considers to be wholly preventable where guidance or safety recommendations that provide strong systemic protective barriers are available at national level and have been implemented by healthcare providers (NHS Improvement 2018). NHS England's provisional summary of Never Events, reported as occurring between 1 April 2022 and 31 March 2023, shows that there were 16 surgical swab and 32 virginal swab incidents during this period.