HospitalInspections.org

Based on record review and interview the Hospital failed to formulate specific criteria for credentialing trainee practioners responsible for providing anesthesia care to patients.


Findings include:

The Resident's credential file indicated that he signed a Delineation of Anesthesia Privileges Form on 6/11/12 which included an understanding of the responsibilities and expectations regarding the attending anesthesiologist supervision of perioperative anesthesia clinical duties. The privilege for maintenance of anesthesia indicated that a resident required Attending Anesthesiologist supervision. The type of supervision, either direct (attending anesthesiologist is physically present at the bedside with the resident) or indirect (the attending anesthesiologist is physically in the hospital, but not at the bedside and is immediately available to provide direct supervision) was not identified.

The Hospital's internal internal investigation indicated that Attending Anesthesiologists (AA) #2 and #3 reviewed with the Resident, in the operating room, the plan to treat Patient (Pt.) #1's high blood potassium level. The plan included the administration of 2 units of insulin and 20 cubic centimeters (cc) of Dextrose 50% (a simple concentrated intravenous sugar solution)] . The Resident did not follow the plan. Pt. #1's medical record indicated that Pt. #1 received 10 units of insulin, not 2 units as planned and did not receive the dextrose.

AA#3 was interviewed on 12/12/12 at 2:45 P.M. AA #3 said she reviewed with the Resident the plan to treat Pt. #1's high potassium blood level in detail. AA #3 said she did not watch the Resident administer the dextrose or the insulin. AA#3 said it was her expectation the Resident would follow the plan.