Pa Patient Saf Advis 2009 Dec;6(4):144.
Corneal Abrasion Injuries
Anesthesiology; Opthalmology; Nursing
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Corneal Abrasion Injuries

In response to an inquiry by a Pennsylvania healthcare facility Patient Safety Officer, staff from the Pennsylvania Patient Safety Authority identified 231 reports that indicated corneal abrasions had occurred between June 2004 and August 2009. Corneal abrasion is the most common ocular injury occurring in the perioperative period.1 Most of the Authority reports (81%) were recognized in the perioperative setting. However, 19% of the reports occurred in diverse care areas such as the medical intensive care unit, the emergency department, on telemetry floors, in radiation oncology, and in labor and delivery wards, leading to the conclusion that all staff should be able to quickly identify, report, and treat corneal abrasions.

See Tables 1 and 2 for the number of reports received by the Authority.

​Table 1. Reports Submitted by Year ​ ​ ​ ​ ​ ​ ​
YEARS ​TOTAL ​PROJECTED
​2004​16*
​2005​47
​2006​34
​2007​44
​2008​52
​2009​38​62
​Total​231255​
* Partial year data (6 months)

† Projection for 2009 based upon 32 weeks of data extrapolated over 52 weeks ​ ​

 

Table 2. Corneal Abrasions by Event Type (Actual Reports June 2004 to August 2009) ​
Event Type Grand Total
Medication error6
Fall1
Error related to procedure/treatment/test23
Complication of procedure/treatment/test142
Skin integrity9
Other/miscellaneous50
Grand Total231

 
Closed claims analysis in 2006 from two major anesthesia-related malpractice databases showed that ocular injuries, in general, account for 3% to 8% of anesthesia-related malpractice claims.2 In 2007, Agency for Healthcare Research and Quality national statistics showed superficial corneal injuries occurred in approximately 1.5% of all hospital discharges; however, not all of these cases represent iatrogenic injuries because some may have been present on admission.3

The lack of information about corneal abrasions prevents the Authority from making new insights about this problem. Reports that are more detailed might be helpful in determining how and why these injuries occur.

Notes

  1. Mecca RS. Postoperative recovery. In: Barash PG, Cullen BF, Stoelting RK, eds. Clinical anesthesia 4th ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2001:1396.
  2. MacRae MG. Closed claims studies in anesthesia: a literature review and implications for practice. AANA J 2007 Aug;75(4):267-75.
  3. United States Department of Health and Human Services. Agency for Healthcare Research and Quality. 2007 national statistics (918.1 superficial injury to the cornea) [online]. [cited2009 Sep 4]. Available from Internet: http://hcupnet.ahrq.gov/HCUPnet.jsp.
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