Patient Safety Alert 33: Patient Safety Alert Guidance to Reduce the Risk of Retained Surgical Items

Retained Surgical Items (RSI) are one of the most frequent sentinel events that were reported by The Joint Commission and the Massachusetts Department of Public Health for 2021-2022. In 2023, the AMC PSO gathered a Task Force to discuss the barriers to, and facilitators for, implementing best practices to reduce retained surgical items (RSI) by reviewing the AORN and AST guidelines through a series of convenings. This document reflects summarized identification of risks and mitigation strategies by the Task Force to reduce RSI’s, including guidance for the implementation of these practices to reduce the incidence of these sentinel events.



Patient Safety Alert: Retained Surgical Objects
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Reduce the Risk of Retained Surgical Items




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