A Screening Tool To Identify Patients At High Risk For Perioperative Neuropathy

Abstract

Purpose: This project aimed to evaluate anesthesia provider attitudes surrounding the clinical topic of perioperative peripheral nerve injury. Additionally, the project sought to introduce anesthesia providers to a novel risk assessment device that may help identify patients at high risk for perioperative peripheral nerve injury while assessing its potential utility in anesthesia practice.Background: Perioperative peripheral nerve injury is a significant cause of patient morbidity and medical litigation. Anesthesia-related lawsuits involving perioperative nerve injury are the second most common type of intraoperative malpractice lawsuit, consistently representing 15-18% of claims (Grant et al., 2019). Research shows that nerve injury is more common in patients with specific comorbidities, predisposing them to nerve damage (Welch et al., 2009). These patients have physiologic characteristics that may be easily identifiable during a preoperative assessment (ASA, 2018). Methods: The project utilized a descriptive design with quantitative evaluation by an electronic survey created by Qualtrics. The survey was distributed to participants following a medicolegal analysis presentation about perioperative peripheral nerve injury and the introduction of a peripheral nerve injury risk assessment tool created by the author. The study's survey gathered data in two main areas, the providers’ opinions and attitudes towards the problem of a perioperative peripheral nerve injury and their view of the presented screening tool’s usefulness. Results: The strongest metrics resulting from the survey showed that anesthesia providers have an increased interest in improving documentation, improving patient assessment efforts, improving patient communication, and perioperative team communication, with the highest metric showing interest in reducing legal risk. When asked if the anesthesia providers could see themselves using the presented screening tool in their clinical practice, 69% of anesthesia providers responded “yes.” Conclusions: The information gained from the project builds awareness of which areas of clinical interest surrounding the topic of perioperative nerve injury are important to anesthesia providers. Feedback gathered from the survey also revealed a positive interest in the potential utility of a risk assessment device, which may help identify patients at high risk for developing a peripheral nerve injury during general anesthesia.