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Use of Nurse Anethetists Alone in OR Safe and on the Rise
A non-profit research group has established that when nurse anesthetists function unsupervised by their MD counterparts, patients are under no greater risk resulting in complications or death. This challenges the requirement that such nurses must be supervised if the surgery is to qualify for Medicare reimbursement. Medicar/Medicaid will allow States to opt out of the requirement through petition. Said researchers reviewed nearly half a million Medicare-covered hospitalizations comparing findings of opt-out and non-opt-out States and determined that the use of a nurse anesthetist alone in the OR is definitely on the rise. This suggests that, as hospitals seek to cut their costs, when it comes to anesthesiology, supervision of such nurses does not compromise patient safety.
Source: Health Affairs, news release, Aug. 3, 2010
Copyright 2010 Health Day, All rights reserved.
Misdiagnosed Heart Attack Claims Highest for Family Practitioners
A recent study of heart attack diagnosis-related medical malpractice claims shows “family practitioners and general internists have highest number of claims and average indemnity payment...of any other physician group.” Acute myocardial infarction is a difficult diagnosis, the study notes, as 70% of claimants reported no prior history of coronary artery disease and 47% were under the age of fifty. The most common diagnostic errors made were gastrointestinal issues, musculoskeletal pain, angina, respiratory ailment, or anxiety. In only 59% of these cases did providers order an EKG; and in nearly 30%, no diagnostic studies were performed. Other errors included misinterpretation of EKG, untimely conveyance of results, not referring patient to another provider, delays in follow-up procedures, discharging the patient from ER, or treating for another diagnosis. The study recommends several risk-management considerations for practitioners either diagnosing or treating heart attacks.
Author: Medmalarts posted by Health & Fitness
htt/://www.lonad.com/2010/08/17/heart-attack-medical-malpractice-suits-hit-primary-care-physicians-hard/
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WHAT'S NEWSWORTHY: Luis Alberto Jimenez, an "undocumented" alien seriously injured in a car accident, was taken to a Florida hospital emergency room for treatment, where he was admitted with a traumatic brain injury and other severe injuries. He was subsequently transferred to a long-term care facility for rehab until he was determined to be "wasting away" in the long-term care facility. He was returned to the hospital ER by ambulance suffering from stage 4 decubitus ulcers and infection. The hospital provided life-saving treatment, and his condition improved to the point that he was functioning at the cognitive level of a 4-year old. He was uninsured and not eligible for federal or state funded long-term care as an illegal alien. The hospital ws caught on the horns of a dilemma--Jimenez no longer required acute hospital care, but no "appropriate facility" would accept him for long-term rehab. Under federal law, if a hospital received any federal funding, it may only discharge or transfer a patient to an "appropriate" facililty for post-hospital care. 42 U.S.C. 1395(ee) & 42 C.F.R. 482. The hospital petitioned the court for perission to transfer Jimenez to a hospital in Guatemala, his native country, and the court agreed, over the objections of Jimenez' guardian and attorney, who argued the care in Guatemala would not meet his client's medical needs. Jimenez was flown out of Florida just hours before the Florida Court of Appeals reversed the decision. In a case of "first impression," the appellate court held that the state court did not have the power to "deport" Jimenez, leaving other issues for future resolution. Cases: MONTEJO GASPAR MONTEJO, as Guardian of the Person of LUIS ALBERTO JIMENEZ, Appellant, v. MARTIN MEMORIAL MEDICAL CENTER, INC., Appellee. CASE NO. 4D03-2638 COURT OF APPEALS OF FLORIDA, FOURTH DISTRICT 874 So. 2d 654; 2004 Fla. App. LEXIS 6263; 29 Fla. L. Weekly D 1089, May 5, 2004, Opinion Filed; Rehearing denied by Montejo v. Martin Mem'l.. 2004 Fla. App. LEXIS 10177 (Fla. Dist. Ct. App. 4th Dist., June 29, 2004. Related proceeding at Montejo v.Martin Mem. Med. Ctr., Inc., 2006 Fla. App. LEXIS 14039 (Fla. Dist. Ct. App. 4th Dist., Aug 23,2006)(holding whether a Mr. Jiminez was falsely imprisoned by the hospital was a question for the jury). References: Zeiger, Anne, Trend: Hospitals Deporting Uninsured Immigrants. http://www.fiercehealthcare.com/story/trend-hospitals-deporting-uninsured-immigrants/2008-08-04#ixzz0wFQT8Jlr retrieved from the internet 8/11/10. WEBSITES TO HELP YOU AVOID MEDICATION ERRORS: The websites below provide accurate information about the consequences of medication errors and ways to avoid such errors.
Drugs and lactation database (National Library of Medicine)
http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Epocrates electronic drug resource
www.epocrates.com
FDA MedWatch
www.fda.gov/Safety/MedWatch/default.htm
Institute for Safe Medication Practices
www.ismp.org
MedlinePlus: Drugs, Supplements, and Herbal Information
www.nlm.nih.gov/medlineplus/druginformation.html
National Coordinating Council for Medication Error Reporting and Prevention
www.nccmerp.org
Source: AmericanNurseToday.com
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