AANA journal
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The analyses of malpractice closed claims conducted by the AANA Foundation Closed Claims Research Team are scientific studies of adverse anesthetic events where a Certified Registered Nurse Anesthetist was identified as potentially contributing to the outcome. From July 2013 to March 2014, the AANA Foundation Closed Claims Researchers evaluated 245 closed claims from the CNA Insurance Companies spanning from 2003 to 2012. ⋯ The purpose of the study was to establish themes that would provide unique insights into the events leading up to death with a focus on the role anesthesia may or may not have had in the outcome. Major themes identified include: (1) patient factors, (2) provider factors, (3) environmental factors, and (4) team/group factors.
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Residual neuromuscular blockade creates excess perioperative morbidity. Quantitative neuromuscular monitoring devices may help ensure full recovery from neuromuscular blocking agents and have been demonstrated to reduce complications associated with residual neuromuscular blockade. We studied the effectiveness of educational efforts to introduce quantitative monitoring at a large academic medical center, with predefined main outcome measures of self-reported familiarity with use of the device and actual device uptake. ⋯ Clinical utilization of the monitors increased from 23% to 40% of eligible cases, with the increased rate sustained in the follow-up period. Education, assessed as improved self-reported proficiency, was associated with measurable increases in utilization of new technology. However, the rate of uptake, even when applied to a problem the users agreed was important, was modest.