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

Williams, Amy (2018-03)

Thesis (MCur)--Stellenbosch University, 2018.

Thesis

ENGLISH SUMMARY: INTRODUCTION The number of medical negligence claims in South Africa has increased rapidly throughout the past decades, affecting both the public and private sectors. RATIONALE Patients are at the receiving end of negligent care provided by healthcare professional workers placing them in a vulnerable and life-threatening position. RESEARCH PROBLEM Factors 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 AIM To investigate factors that contributed to malpractice litigation within the private healthcare sector in Gauteng. RESEARCH OBJECTIVES The 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 setting RESEARCH METHODOLOGY Research design A quantitative retrospective descriptive audit research design was applied. Population and sampling Convenience 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 criteria Malpractice 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 collection The researcher collected all the data using a validated audit instrument based on the objectives. Reliability The reliability of the audit instrument was tested by applying the test-retest method. Validity Content validity Content 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 validity The co-investigators of the main study, experts in quality assurance and the bio-statistician agreed that the instrument was valid. Data analysis The 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 CONSIDERATIONS Ethical 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 care RESULTS This 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. CONCLUSION It has been highlighted that the clinical management of the patient is a major problem as well as the adherence to the policies and protocols.

AFRIKAANSE OPSOMMING: INLEIDING Die getal van mediese nalatigheid eise in Suid-Afrika het vinnig oor die dekades verhoog en beïnvloed beide die openbare en private sektore. RASIONAAL Pasiënte is die ontvangers punt van nalatige mediese sorg wat deur professionele gesondheidsorgwerkers verskaf word, wat hulle in 'n kwesbare en lewensgevaarlike posisie plaas. NAVORSING PROBLEEM Faktore wat lei tot wanpraktyk litigasie in verpleegpraktyk binne die privaatsektor in Suid-Afrika is onbekend, dus was 'n wetenskaplike ondersoek nodig. NAVORSING VRAAG "Wat is die faktore wat bydra tot wanpraktyk litigasie in verpleegpraktyk binne die private gesondheidsorg sektor van Gauteng?" NAVORSING DOEL Om die faktore wat bygedra het tot wanpraktyk litigasie binne die private gesondheidsorg sektor in Gauteng te ondersoek. NAVORSING DOELWITTE Die doelwitte vir die studie het ingesluit: •Voltooi 'n oudit van die verpleegprosesdokumente van 'n verhoor bondel• Kategoriseer die nadelige gebeurtenisse volgens beginseltipe waarin verpleegpraktisyns betrokke was wat tot wanpraktyk litigasie gelei het. •Identifiseer die faktore wat aanleiding tot nadelige gebeurtenisse gegee het wat tot wanpraktyk litigasie gelei het, waarby verpleegpraktisyns betrokke was. •Identifiseer van die ander lede van die multi-dissiplinêre gesondheidspan wat 'n rol gespeel het in die nadelige gebeurtenis wat tot wanpraktyk litigasie gelei het. •Beraam die erns van die nadelige gebeurtenis wat gelei het tot wanpraktyk litigasie bine die privaat gesondheidsorg sektor. NAVORSINGSMETODIEK Navorsing ontwerp ‘n Kwantitatiewe, terugwerkende beskrywende oudit navorsingontwerp is aangewend. Populasies en steekproef Gerieflikheids steekproefneming is toegepas om 41 wanpraktyklitigasie gevalle te kies wat in die private gesondheidsorg sektor van Gauteng oor 'n tydperk van ses jaar plaas gevind het. Insluiting kriteria Wanpraktyk litigasie gevalle waarby die privaat hospitale in Gauteng gedurende 2011-2016 betrokke was. Uitsluiting kriteria Enige wanpraktyk litigasie saak wat in die loodsstudie gebruik is, sowel as enige gevalle wat dalk baie media-aandag ontvang het. Data instrument en data versameling Die navorser het met behulp van 'n geldige instrument, gebaseer op die doelwitte data versamel Betroubaarheid Die betroubaarheid van die oudit instrument is getoets deur die toepassing van die toets-hertoets metode. Geldigheid Inhoud geldigheid Die inhoud van die oudit instrument is op die doelwitte gebaseer, gelei deur die konsepsuele teoretiese raamwerk en literatuur, en deur kundiges bevestig dat alle elemente vir meting ingesluit is. Aangesig geldigheid Die mede-navorsers van die hoofstudie, kundiges in gehalteversekering en die biostatistiekus het ingestem dat die instrument geldig was. Data analise Die data is met behulp van die Statistiese Pakket vir Sosiale Wetenskappe (SPSS) ontleed, wat die navorser instaat gestel het om die beginseltipe te kategoriseer en die faktore wat bydra tot die nadelige gebeurtenisse wat in verpleeg praktyk tot litigasie gelei het te, identifiseer. ETIESE OORWEGINGS Etiese goedkeuring is verleen voor die aanvangs van die studie van die volgende organisasies: • Navorsing Gesondheid Etiese Komitee (Universiteit Stellenbosch, S16/10/222) • Toestemming van wetgewende maatskappye wat in wanpraktylitigasie in gesondheidsorg spesialisee RESULTATE Hierdie studie het aan die lig gebring dat meeste (46.3%) nadelige gebeurtenisse ernstig was waarvan 7.3% van die pasiënte gesterf het. Verder, is geïdentifiseer dat in 75.6% van die nadelige gebeurtenisse, kliniese manifestasies. nie op gerespondeer was nie GEVOLGTREKKING Dit is uitgelig dat die kliniese hantering van die pasiënt, sowel as die nakoming van die beleid en protokolle groot problem is.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/103742
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