Development and validation of an instrument for procedure-related death notification

Area of Science:

• Medical Science
• Anaesthesiology
• Forensic Pathology

Background:

• Anaesthesia-related mortality is a significant cause of preventable perioperative deaths.
• The current South African Procedure-Related Death Notification (PRDN) instrument (GW7/24 form) is outdated and requires revision.
• PRDN instruments are crucial for auditing practice, medicolegal investigations, and litigation.

Purpose of the Study:

• To develop and validate a revised anaesthetic section for the South African PRDN instrument.
• To create an updated form for future use in procedure-related deaths.
• To provide a template for revising the existing GW7/24 form for various uses.

Main Methods:

• Utilized Lynn's two-stage model, starting with an extensive literature review.
• Developed a provisional instrument, reviewed by 6 local anaesthetic and forensic pathology experts.
• Rated a revised instrument by 8 national experts using a Likert scale and calculated the Content Validity Index (CVI).

Main Results:

• The provisional instrument had 14 domains and 66 items; the revised had 13 domains and 65 items.
• Three items with a CVI <0.88 were removed.
• The final instrument comprised 18 domains and 79 items, achieving an overall CVI of 1, with all items deemed relevant.

Conclusions:

• A comprehensive, updated, and validated anaesthetic section for the SA PRDN instrument has been successfully developed.
• This new instrument can serve as a government and anaesthesiology society-endorsed template.
• The validated instrument will improve the accuracy and utility of procedure-related death notifications.