Investigation into the factors that contribute to malpractice litigation in nursing practice within the private healthcare sector of Gauteng

[摘要] ENGLISH SUMMARY: INTRODUCTIONThe number of medical negligence claims in South Africa has increased rapidly throughout the past decades, affecting both the public and private sectors.RATIONALEPatients are at the receiving end of negligent care provided by healthcare professional workers placing them in a vulnerable and life-threatening position.RESEARCH PROBLEMFactors leading to malpractice litigation in nursing practice within the private sector in South Africa are unknown, thus a scientific investigation was required.RESEARCH QUESTION'What are the factors that contribute to malpractice litigation in nursing practice within the private healthcare sector of Gauteng?RESEARCH AIMTo investigate factors that contributed to malpractice litigation within the private healthcare sector in Gauteng.RESEARCH OBJECTIVESThe objectives for the study included:• To complete an audit of the nursing process documents of a trial bundle• Categorising the adverse events according to principle type leading to malpractice litigation that involved nursing practitioners.• Identifying the factors contributing to the adverse events that have led to malpractice litigation, involving nursing practitioners.• Identifying the other members of the multi-disciplinary health team that played a role in the adverse event that has resulted in malpractice litigation• Assessing the severity of the adverse event that has led to malpractice litigation within the private healthcare settingRESEARCH METHODOLOGYResearch designA quantitative retrospective descriptive audit research design was applied.Population and samplingConvenience sampling was applied to select 41 malpractice litigation cases which occurred in the private healthcare sector of Gauteng over a period of six years.Inclusion criteriaMalpractice litigation cases involving the private hospitals in Gauteng during 2011-2016.Exclusion criteria Any malpractice litigation case that has been used in the pilot study as well as any cases that might have received much media attention.Data instrument and data collectionThe researcher collected all the data using a validated audit instrument based on the objectives.ReliabilityThe reliability of the audit instrument was tested by applying the test-retest method.ValidityContent validityContent of the audit instrument was based on the objectives, guided by the conceptual theoretical framework, literature and confirmed by experts that all elements to be measured were covered.Face validityThe co-investigators of the main study, experts in quality assurance and the bio-statistician agreed that the instrument was valid.Data analysisThe data were analysed by using the Statistical Package for the Social Sciences (SPSS) version 23 which enabled the researcher to categorise into principle type and to identify factors contributing to adverse events in nursing practice which lead to malpractice litigation.ETHICAL CONSIDERATIONSEthical approval was sought prior to the study from the following organisations:• Health Research Ethics Committee (Stellenbosch University, S16/10/222)• Permission from law firms specialising in malpractice litigation in health careRESULTSThis study revealed that most adverse events were severe (46.3%) of which 7.3% of the patients died.Furthermore, it was identified that in 75.6% of the adverse events, clinical manifestations were not responded to.CONCLUSIONIt has been highlighted that the clinical management of the patient is a major problem as well as the adherence to the policies and protocols.

[发布机构] Stellenbosch University