Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
S Afr Med J. 2020 Jan 29;110(2):140-144. doi: 10.7196/SAMJ.2020.v110i2.14083.
Anaesthesia-related mortality is an important, potentially avoidable cause of perioperative mortality. A procedure-related death notification (PRDN) instrument is completed by relevant medical practitioners after a procedure-related death and is used to audit practice and identify areas of care that require improvement. It is also used in medicolegal investigations when establishing cause of death, and in the case of litigation. The current South African (SA) PRDN instrument, designated the GW7/24 form, contains both surgical and anaesthetic sections and is considered to be outdated, inadequate and in need of revision.
To develop and validate a revised anaesthetic section of the SA PRDN instrument that can be used for procedure-related deaths in future and be used to update the GW7/24 form for epidemiological, forensic or academic use.
Lynn's two-stage model was utilised. After an extensive literature review, a provisional PRDN instrument was developed. This provisional instrument was debated and reviewed at a peer group discussion in which 6 local experts took part. These experts were anaesthetic and forensic pathology specialists who specifically have expert knowledge on procedure-related deaths. A revised PRDN instrument was developed, which was then rated by 8 national experts using a Likert scale. The content validity index (CVI) for each item and for the instrument as a whole was then established. Items with a CVI <0.88 were removed to formulate the final PRDN instrument.
The provisional PRDN instrument consisted of 14 domains and 66 items. The revised PRDN instrument consisted of 13 domains and 65 items, of which 3 items with a CVI <0.88 were removed. The final PRDN instrument, after minor revisions based on suggestions from the 8 national experts, consisted of 18 domains and 79 items. Every item on the form was declared relevant and important by the national experts, with the final instrument scoring an overall CVI of 1.
A comprehensive, updated and validated anaesthetic section of the SA PRDN instrument was developed. This could be used as a government and anaesthesiology society-endorsed template when updating the current GW7/24 form.
麻醉相关死亡率是围手术期死亡的一个重要的、潜在可避免的原因。在发生与操作相关的死亡后，相关医务人员会填写操作相关死亡通知（PRDN）表格，该表格用于审核实践并确定需要改进的护理领域，还可在确定死因和进行医疗诉讼时用于法医学调查。目前南非（SA）的 PRDN 表格 GW7/24 既包含外科部分也包含麻醉部分，被认为是过时的、不充分的，需要修改。
开发和验证南非 PRDN 表格的修订版麻醉部分，以便将来用于与操作相关的死亡，并用于更新 GW7/24 表格以用于流行病学、法医或学术用途。
利用林恩的两阶段模型。在广泛的文献回顾后，制定了临时 PRDN 表格。该临时表格在同行小组讨论中进行了辩论和审查，其中 6 名当地专家参与了讨论。这些专家是麻醉和法医病理学专家，他们专门对与操作相关的死亡具有专业知识。制定了修订后的 PRDN 表格，然后由 8 名国家专家使用李克特量表进行评分。然后确定每个项目和整个仪器的内容有效性指数（CVI）。CVI <0.88 的项目被删除，以形成最终的 PRDN 表格。
临时 PRDN 表格包含 14 个领域和 66 个项目。修订后的 PRDN 表格包含 13 个领域和 65 个项目，其中 3 个项目的 CVI <0.88 被删除。根据 8 名国家专家的建议进行了微小修订后，最终的 PRDN 表格包含 18 个领域和 79 个项目。国家专家认为表格上的每个项目都是相关和重要的，最终仪器的总 CVI 为 1。
制定了全面、更新和验证的南非 PRDN 表格的麻醉部分。这可以用作政府和麻醉学会更新当前 GW7/24 表格时认可的模板。
