Elgharably, Ahmed NaderDesai, KiranNevill, Alan M.Vance, AaronLester, JonBonfiglio, EmmaRigby, ColinForrester, AndrewOgrodnik, PeterFaint, JeffreyClutton-Brock, TomDesai, Aditi2024-09-302024-09-302024-08-30Elgharably AN, Desai K, Nevill AM, et al (2024) iCount: a human-factors engineered solution to vaginal swab retention – an early-stage innovation report. BMJ Innovations, 10 (4), pp. 129-135. doi: 10.1136/bmjinnov-2024-0012482055-807410.1136/bmjinnov-2024-001248http://hdl.handle.net/2436/625719© 2024 The Authors. Published by BMJ. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1136/bmjinnov-2024-001248WHAT ARE THE NEW FINDINGS Despite established policies and procedures when swab counting, issues such as distraction, confirmation bias, competing task priorities and changes in swab appearance contribute to swab miscounts and therefore swab retention. Cases of count discrepancies/miscounts are under-reported, and their impact extends to patient’s health, clinician’s time and trust’s reputation and finances. iCount is a low-cost device designed and developed with human factors-ergonomics principles. It is a docking system that behaves as a physical checklist when swab counting and facilitates conscious engagement using visual and tactile cues when counting. Users believe iCount to be a viable alternative to manual two-person swab counting with greater time efficiency and perceived safety. This could be valuable in emergency maternity situations. HOW MIGHT IT IMPACT ON HEALTHCARE IN THE FUTURE iCount has the potential to reduce or prevent retained swabs after vaginal deliveries along with appropriate policies, training and teamwork. Additional clinical research and widespread adoption would be needed to validate this effectively.application/pdfenvaginal swabsvaginal swab retentionJournal article2055-642XBMJ Innovations2024-09-29