Factors influencing adverse events resulting in malpractice litigation in nursing practice in private hospitals in the Western Cape

[摘要] ENGLISH SUMMARY: Patient safety is the focus of the healthcare environment. However, the incidences of medical negligence leading to malpractice litigation cases are increasing globally.The aim of this study was to investigate factors that influence adverse events resulting in malpractice litigation in nursing practice in private hospitals in the Western Cape, which is a sub-study to the principle study 'A retrospective analysis of malpractice litigation in nursing practice in South Africa. The ethics approval for the main study is confirmed by reference number N16/02/027. The research question was 'What are the factors that influence adverse events resulting in malpractice litigation in nursing practice in private hospitals in the Western Cape?The objectives included: Complete an audit analysis of the nursing process Categorise the adverse events into principle types Determine factors associated with the adverse events involving the nurse practitioners that have resulted in malpractice litigation Identify other healthcare team members who may be associated with the adverse events that have resulted in malpractice litigation Assess the severity of the adverse events associated with malpractice litigation.A quantitative, retrospective audit research design was used for the purpose of this study.The study focused on malpractice litigation cases that occurred in private hospitals in the Western Cape.A convenience sample was applied. Seven attorneys, who had a variety of cases from various private hospitals within the Western Cape, granted the researcher permission to audit a total of 81 trial bundles.The test-retest method was applied to ensure the instrument included all required information to audit the trial bundles. The main study conducted a pilot study which confirmed reliability of the instrument.Expert opinions were obtained to ensure validity of the instrument. A rigorous process ensured face and content validity. The pilot study which is a sub study was conducted for the main study and not repeated in this study.The individual trial bundles were audited with the use of an audit instrument at the offices of the attorneys who specialised in malpractice litigation cases. With the support of the biostatistician, a descriptive analysis was completed and presented in tables and graphs. Ethical approval (S16/10/204) was granted by the Faculty of Medicine and Health Science at Stellenbosch University.The researcher found that n=49 (60.5%) of the cases were settled out of court. Clinical manifestations were not recorded in n=62 (76.5%) of the trial bundles. Clinical management was the most common principle type found, n=72 (88.9%). The majority of the adverse events were extreme, n=29 (35.8%) resulting in death or disability.The recommendations include encouraging continuous professional development, improving supervision in the clinical environment, promoting the 'Just Culture' within the healthcare environment to encourage reporting of adverse events: thereby allowing measures to be put into place to prevent a recurrence of the adverse event.

[发布机构] Stellenbosch University