Risk management in neonatal perinatal medicine:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2005
|
| Schriftenreihe: | Clinics in perinatology
32,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV, 300 S. Ill., graph. Darst. |
| ISBN: | 1416027548 |
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| 650 | 7 | |a Complicaties |2 gtt | |
| 650 | 7 | |a Perinatale geneeskunde |2 gtt | |
| 650 | 7 | |a Risk management |2 gtt | |
| 650 | 7 | |a Zwangerschap |2 gtt | |
| 650 | 4 | |a Emergencies |x Infant, Newborn | |
| 650 | 4 | |a Infant, Newborn, Diseases |x prevention and control | |
| 650 | 4 | |a Liability, Legal |z United States | |
| 650 | 4 | |a Malpractice |x legislation and jurisprudence |z United States | |
| 650 | 4 | |a Medical Errors |x prevention & control | |
| 650 | 4 | |a Medical personnel |x Malpractice | |
| 650 | 4 | |a Neonatology | |
| 650 | 4 | |a Newborn infants |x Medical care | |
| 650 | 4 | |a Newborn infants |x Wounds and injuries |x Prevention | |
| 650 | 4 | |a Newborn infants |x Wounds and injuries |x Treatment | |
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| 650 | 4 | |a Physician-Patient Relations | |
| 650 | 4 | |a Risk Management | |
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Datensatz im Suchindex
| _version_ | 1804133258613489664 |
|---|---|
| adam_text | KISK MANAi.K.MENT I NF.ONAI AL PERINATAI.MFDICINE
CONTENTS
Preface xiii
Marcus C. Hermansen
Perinatal Risk Management: Obstetric Methods to Prevent
Birth Asphyxia 1
Jeffrey P. Phelan
Because obstetric care frequently is associated with the potential
for liability, the purpose of this article is to familiarize the reader
with perinatal risk management using the concept of foreseeability
of harm and its potential application to obstetric care. At the same
time, this article introduces the concept of notice, and explains the
critical conduct intervals that are used to gauge how well the
health care teams handle obstetric emergencies. The focus then
shifts to incorporate these concepts into several maternal child
health quality management programs. It is hoped that this article
will result in an improvement of perinatal outcome for pregnant
women and their unborn children.
Management of Birth Injuries 19
Michael R. Uhing
Birth injuries are a significant cause of neonatal morbidity and
mortalitv. Although often associated with traumatic delivery, birth
injuries often occur in normal spontaneous deliveries in the
absence of any risk factors. This article discusses the diagnosis and
management of the most common birth injuries that are encoun¬
tered by health care providers who care for newborns.
Birth Injuries of the Brachial Plexus 39
Joseph H. Piatt, Jr
Birth injuries of the brachial plexus are fairly common, but the
majority of affected newborns make quick recoveries without
any specific intervention. A minority suffers more severe injuries
VOLUME 32 • NUMBER 1 • MARCH 2005 v
that lead to varying degrees of life long disability. Happily, mod¬
ern microsurgical techniques permit reconstruction of certain
plexus injuries and, in carefully selected patients, can restore
voluntary activity to target muscle groups. To what degree rean
imation of paralyzed muscles improves function and quality of
life for these children is a more important matter that has not yet
been addressed at the level of modern standards of evidence.
Brachial plexus reconstruction is only a first step in the multi
disciplinary process needed to optimize long term functional
outcomes for severely affected infants.
Birth Asphyxia and Cerebral Palsy 61
Jeffrey P. Phelan, Gilbert I. Martin, and Lisa M. Korst
There has been a societal presumption that most, if not all, cases of
hypoxic ischemic encephalopathy induced cerebral palsy occur
during the 3 hours that are related to the events of labor and deliv¬
ery; society has tended to overlook the remaining 7000 hours of the
pregnancy. As a result of this societal perspective, oftentimes the
obstetrician has been targeted unfairly as the person who is
responsible for a given child s neurologic injuries. Rather, the
entire pregnancy, labor, delivery, and well beyond birth require
examination to understand fully the pathophysiologic mecha¬
nisms that are responsible for an infant s brain injuries, and their
long term impact on the child.
Pitfalls in Neonatal Resuscitation 77
Marcus C. Hermansen and Mary Goetz Hermansen
Ten percent of all newborns require resuscitation at birth. The
Neonatal Resuscitation Program establishes the authoritative tech¬
nique of newborn resuscitation. Errors continue to occur that are
related to the use of unskilled resuscitators; intubation; inadequate
suctioning of meconium; and the postresuscitation problems of
hypoglycemia, hypocarbia, and hypotension. Specific recommen¬
dations are offered to avoid these pitfalls of neonatal resuscitation.
Patient Safety in the Neonatal Intensive Care Unit 97
William H. Edwards
Patient safety has become a national priority. This article reviews
issues of patient safety in neonatal intensive care. Safety goals for
2005 set by the Joint Commission on Accreditation of Healthcare
Organizations are discussed from the perspective of relevance to
neonatal intensive care.
vi CONTENTS
Prevention of Medication Errors 107
Christoph U. Lehmann and George R. Kim
Medication error is the most frequent source of medical error
that is associated with adverse events, and, in many cases, is pre¬
ventable. Medication errors can occur at any step in the medica¬
tion process. Medication error prevention and reduction begins
with a systematic approach to their detection. An important
approach to mitigating errors involves the reduction of variation
in task performance using tested techniques and technologies
from other industries. The most important component of error
prevention and reduction is the proactive promotion of a safety
culture by organizational leadership, with sustained education
and support for users.
Risk Management of Severe Neonatal Hyperbilirubinemia to
Prevent Kernicterus 125
Vinod K. Bhutani, Steven M. Donn, and Lois H. Johnson
Our approach for risk management of severe neonatal hyper¬
bilirubinemia to prevent kernicterus—one of the most easily
preventable causes of neonatal brain damage—includes man¬
agement of certain high risk clinical situations, identification of
systems failure, and suggestions for implementation strategies
to enhance patient safety.
Intravascular Catheter Complications in the Neonatal Intensive
Care Unit 141
Marcus C. Hermansen and Mary Goetz Hermansen
Central and peripheral intravascular catheters serve many impor¬
tant functions for sick neonates; however, the use of these catheters
also carries significant risk of permanent disability or even death.
This article examines the risks of catheter related thromboembolic
events, vasospasm, and infection. The article also looks at risks that
are specific to umbilical artery catheters, umbilical vein catheters,
peripherally inserted central catheters, peripheral artery catheters,
and peripheral intravenous catheters. Specific recommendations
are made to reduce the possibility of an intravascular catheter
related complication.
Talking About the Unthinkable: Perinatal/Neonatal
Communication Issues and Procedures 157
Susan Fox, Frederic W. Platt, Maysel Kemp White,
and Peter Hulac
Clinician parent conversations in perinatology and neonatology
are demanding. They take place over a period of time and ask
much of the clinician. Many parents insist that they want thorough
CONTENTS vii
explanations so they can understand the medical information and
its impact on them. These cases involve copious amounts of
medical and resource information and parents cannot assimilate it
all at one time; thus, these conversations are extended dialogs.
Conversational skills that seem essential for clinicians in this work
include giving bad news, sharing information, and expressing
empathy. Underlying the conversational skills are those habits that
form the complete physician: curiosity that leads one to learn the
parents values; the skill to help parents apply these values as they
make difficult decisions; patience to listen to and stick with these
suffering people who are full of strong emotions; and finally, the
courage and endurance to confront these difficult situations day
after day.
A Defense Attorney s Perspective on Medical
Negligence Litigation 171
Richard H. Donohue
Being named as a defendant in a lawsuit is an unnerving develop¬
ment. Proceeding through the discovery stage of a case can be a
daunting prospect. Sitting through a trial, in which one s profes¬
sional conduct is judged by six or twelve laypersons with little or
no medical knowledge, often is gut wrenching. In this day and
age, many physicians, including extremely well qualified specialists,
often must deal with these realities. To cope best with these events,
this article is an attempt to summarize certain legal principles that
are relevant to these cases and to emphasize the practical realities
that are attendant to medical negligence litigation.
A Plaintiff Attorney s Candid View of Medical Malpractice 191
David J. Pritchard
The human dynamics of medical malpractice litigation is more
nuanced than many doctors suspect. The purpose of this article is
to provide some candid insights into the process. The article pres¬
ents three subjects that doctors are not likely to learn on their own,
even if they read all of the law books or had the misfortune of run¬
ning the gauntlet of their own medical malpractice lawsuit. Those
subjects are: (1) the top five reasons why doctors get sued, (2)
avoiding less than optimal legal representation, and (3) the impor¬
tance of nonmedical issues in litigation.
Malpractice Crisis and Reform 203
Randall R. Bovbjerg
Medical liability coverage has become increasingly expensive
and scarce since 2001, especially for obstetrics and other high risk
specialties. Physicians, whose own fees are constrained, see this
as a crisis needing tort reform to cap payouts. Plaintiffs lawyers
viii CONTENTS
fight caps; they blame insurance trends and call for stronger
regulation of insurers and physicians. Doctors arguments are
somewhat better than lawyers about insurance developments,
but the huge tort reform battle wholly ignores the biggest prob¬
lems—the medical system has too many preventable medical
injuries, and the legal system fails to prevent them. It is time to try
out better approaches, three of which are discussed in this paper.
Malpractice Reforms: Are They Fair? 235
Maxwell J. Mehlman
In the debate over medical malpractice reform, the dimension of
fairness often is invoked but is poorly understood. This article
describes the factors that promote fairness in public policy and
then examines whether proposed or enacted tort reforms would be
fair. It finds that many of the reforms that are being promoted by
perinatologists would be unfair; however, some reforms, including
one broad ranging proposal that was put forward by the Institute
of Medicine, could satisfy fairness criteria depending on how they
were implemented.
Evidence based Expert Testimony 251
William Meadow
Expert witnesses undoubtedly know a great deal about topics on
which ordinary people lack information. But experts, no less than
other people, are subject to predictable memory biases. No plain¬
tiff lawyer can enter the courtroom alone, without a doctor by his
or her side to serve as an expert witness. The behavior of the plain¬
tiff s experts (and the behavior of the experts who walk alongside
the defense lawyers as well) is the subject of this article. What
should guide expert testimony? How should those guidelines be
implemented? How has our profession dealt with these issues?
Perinatal Litigation and Related Nursing Issues 277
Patricia A. Dunn, Mary Lou Gies, and Mary Anne Peters
Obstetric and neonatal nurses are expected to provide an abun¬
dance of guidance, support, monitoring, and education to women
and their babies during and after delivery. Nurses should adhere
to standards of professional nursing practice. This will ensure that
optimal and safe care is provided for the mother and fetus or
neonate. Perinatal nurses are vulnerable to litigation should com¬
plications occur. Perinatal nurses are responsible for providing
routine assessments as well as initiating and performing emer¬
gency interventions. This includes recognition of the symptoms of
complications in the mother and the neonate, resuscitation, and
activation of the emergency system. Occasionally, nurses are
CONTENTS ix
obliged to question the practice of other health care providers.
Although perinatal nurses continue to be at risk for malpractice
vulnerability, risk reduction techniques are available to them. This
article provides the nurse with knowledge of legal proceedings and
strategies to reduce liability when caring for pregnant women
and newborns.
Index 291
x CONTENTS
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| spelling | Risk management in neonatal perinatal medicine guest ed.: Marcus C. Hermansen Philadelphia [u.a.] Saunders 2005 XIV, 300 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Clinics in perinatology 32,1 Complicaties gtt Perinatale geneeskunde gtt Risk management gtt Zwangerschap gtt Emergencies Infant, Newborn Infant, Newborn, Diseases prevention and control Liability, Legal United States Malpractice legislation and jurisprudence United States Medical Errors prevention & control Medical personnel Malpractice Neonatology Newborn infants Medical care Newborn infants Wounds and injuries Prevention Newborn infants Wounds and injuries Treatment Obstetrical Nursing legislation & jurisprudence United States Physician-Patient Relations Risk Management Risikogeburt (DE-588)4178225-2 gnd rswk-swf USA (DE-588)4143413-4 Aufsatzsammlung gnd-content Risikogeburt (DE-588)4178225-2 s b DE-604 Hermansen, Marcus C. Sonstige oth Clinics in perinatology 32,1 (DE-604)BV000003382 32,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=013102533&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Risk management in neonatal perinatal medicine Clinics in perinatology Complicaties gtt Perinatale geneeskunde gtt Risk management gtt Zwangerschap gtt Emergencies Infant, Newborn Infant, Newborn, Diseases prevention and control Liability, Legal United States Malpractice legislation and jurisprudence United States Medical Errors prevention & control Medical personnel Malpractice Neonatology Newborn infants Medical care Newborn infants Wounds and injuries Prevention Newborn infants Wounds and injuries Treatment Obstetrical Nursing legislation & jurisprudence United States Physician-Patient Relations Risk Management Risikogeburt (DE-588)4178225-2 gnd |
| subject_GND | (DE-588)4178225-2 (DE-588)4143413-4 |
| title | Risk management in neonatal perinatal medicine |
| title_auth | Risk management in neonatal perinatal medicine |
| title_exact_search | Risk management in neonatal perinatal medicine |
| title_full | Risk management in neonatal perinatal medicine guest ed.: Marcus C. Hermansen |
| title_fullStr | Risk management in neonatal perinatal medicine guest ed.: Marcus C. Hermansen |
| title_full_unstemmed | Risk management in neonatal perinatal medicine guest ed.: Marcus C. Hermansen |
| title_short | Risk management in neonatal perinatal medicine |
| title_sort | risk management in neonatal perinatal medicine |
| topic | Complicaties gtt Perinatale geneeskunde gtt Risk management gtt Zwangerschap gtt Emergencies Infant, Newborn Infant, Newborn, Diseases prevention and control Liability, Legal United States Malpractice legislation and jurisprudence United States Medical Errors prevention & control Medical personnel Malpractice Neonatology Newborn infants Medical care Newborn infants Wounds and injuries Prevention Newborn infants Wounds and injuries Treatment Obstetrical Nursing legislation & jurisprudence United States Physician-Patient Relations Risk Management Risikogeburt (DE-588)4178225-2 gnd |
| topic_facet | Complicaties Perinatale geneeskunde Risk management Zwangerschap Emergencies Infant, Newborn Infant, Newborn, Diseases prevention and control Liability, Legal United States Malpractice legislation and jurisprudence United States Medical Errors prevention & control Medical personnel Malpractice Neonatology Newborn infants Medical care Newborn infants Wounds and injuries Prevention Newborn infants Wounds and injuries Treatment Obstetrical Nursing legislation & jurisprudence United States Physician-Patient Relations Risk Management Risikogeburt USA Aufsatzsammlung |
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