News Video | Policy | GPs | Hospitals | Medical | Mental Health | Welfare | Search


Adherence to count policy in surgery

Health and Disability Commissioner Anthony Hill today released a report finding a medical centre and surgeon in breach of the Code of Health and Disability Services Consumers’ Rights for the surgical care provided to a woman.

Four days after the woman’s surgery at the medical centre’s onsite theatre, the woman discovered a gauze swab that had been inadvertently left inside her operation site.

Mr Hill found that the theatre nurses did not complete an initial count of swabs and sharps (anything sharp used during a procedure, such as needles) before the surgery began, record that the gauze swab had been inserted during the surgery, or complete a closing count at the end of the surgery. The surgeon then failed to confirm the status of the count at the end of the surgery, as required by the medical centre’s count policy.

"A surgical count-in and count-out process is an important communication and team-work tool, which ensures the safety of the patient in the operating room. I am concerned that this process was carried out poorly by staff… As the senior clinician in the room, it was the surgeon’s responsibility to ensure the counting procedures were adhered to," Mr Hill said.

Mr Hill also found the medical centre’s count policy lacked sufficient detail, and that staff were unsure about their roles and responsibilities in the counting process.

"This case is an example of the need to be constantly vigilant to ensure communication is effective, policies are clear, and that they are complied with."

Mr Hill recommended that the medical centre and surgeon provide a written apology to the woman, and that the medical centre report on its use of the Surgical Safety Checklist and carry out an audit on compliance with its count policy.

The full report for case 17HDC02250 is available on the HDC website.


© Scoop Media

Culture Headlines | Health Headlines | Education Headlines


Howard Davis: Controlling the High Ground

Stephen Johnson's raw and angry film not only poses important questions with scrupulous authenticity, but also provides a timely reminder of the genocidal consequences of casual bigotry and xenophobia. More>>

Howard Davis: Dryzabone - Robert Conolly's The Dry

After the terrible devastation caused by last year’s bushfires, which prompted hundreds of Australians to shelter in the ocean to escape incineration and destroyed uncountable amounts of wildlife, The Dry has been released during a totally different kind of dry spell. More>>

Howard Davis: Benjamin Ree's The Painter and The Thief

The Norwegian filmmaker had long been fascinated by art thieves who commit high-stakes crimes with a delicate touch when a chance Google search in 2015 uncovered a botched heist in Oslo. More>>

Howard Davis: Hit the Road, Jack - Chloé Zhao's Nomadland

Nomadland is perhaps the ultimately 'road' movie as it follows a group of dispossessed and disenfranchised vagabonds who find a form of communal refuge in camp sites and trailer parks after the economic contraction of 2008. More>>

Howard Davis: Byrneing Down the House - Spike Lee's American Utopia

Lee does an admirable job capturing Byrne's stunning live performance of his latest album, but the real star of the show is the staging. More>>

Howard Davis: The Phoenix Foundation Friend Ship Tour Docks in Wellington

A sense of local pride was certainly running high at the Opera House on Saturday night, as the lads ran through a tasty little set drawn mostly from their latest album Friend Ship (splash out for Xmas on the shocking pink extra-thick vinyl edition). More>>



  • Wellington
  • Christchurch
  • Auckland