Improving Patient Outcomes Through Closed-Claims Analysis: Salient Characteristics and Patterns Associated With Respiratory Events.
AANA J
; 86(3): 201-208, 2018 Jun.
Article
em En
| MEDLINE
| ID: mdl-31580808
ABSTRACT
A retrospective, exploratory research design was used to analyze salient characteristics and patterns associated with closed claims involving Certified Registered Nurse Anesthetists (CRNAs) in which a respiratory event caused the adverse outcome. Alleged malpractice acts found in these claims occurred between 2003 and 2012. Respiratory events were the most frequent cause of adverse outcomes in the current database (34%). The respiratory adverse outcomes often resulted in mortality or significant and permanent morbidity (69%) and were largely preventable (81%). Of these respiratory outcomes, inadequate ventilation and oxygenation associated with respiratory depressant medications accounted for 37% of the adverse outcomes (hypoventilation = 27.4%; respiratory arrest = 9.5%). In every hypoventilation claim, regardless of the type of anesthetic technique, a failure to optimally monitor the patient's ventilation was identified as a sentinel, contributory practice pattern. Payouts for CRNAs were made in 55% of respiratory claims and averaged $282,840. Claims judged to have an AANA standard-of-practice guideline violation that directly contributed to the adverse outcome were more likely to result in a payout vs those involving no violation (P <.01). Costs to defend against the malpractice allegation for all respiratory event claims averaged $51,996 (SD = $52,658) and ranged from $525 to $227,153.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Respiratória
/
Avaliação de Resultados da Assistência ao Paciente
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Período Intraoperatório
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Imperícia
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Enfermeiros Anestesistas
Tipo de estudo:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
AANA J
Ano de publicação:
2018
Tipo de documento:
Article