Nursing specialties with the highest average paid indemnity claims during 2006-2010 were obstetrics, neurology/neurosurgery and plastic/reconstructive surgery, according to a report issued by an Aon Corp.

The report by the Hatboro, Pa.-based Nurses Services Organization, a division of Aon Affinity, in collaboration with CNA Healthpro, a unit of Chicago-based CNA Insurance Cos., also includes risk control recommendations.

The report examines 516 closed nurse claims based on several criteria, including having been closed between Jan. 1, 2006, and Dec. 31, 2010, and having indemnity payments of more than $10,000 made on behalf of the insured nurse by CNA.

According to the study, the obstetrics specialty accounted for 10.3% of all claims and has an average paid indemnity of $382,353. Neurology/neurosurgery, which accounted for 0.6% of all claims, had a $379,000 average paid indemnity, and plastic/reconstructive surgery, which accounted for 0.8% of all claims, had a $324,375 average paid indemnity.

The highest percentage of claims among specialties was adult medical/ surgical, which accounted for 40.1% of all claims and had an average paid indemnity of $143,969, according to the study.

The total paid indemnity for all 516 claims totaled $83.3 million, with an average paid indemnity of$161,501.

Among other study findings, 91.9% of the claims involved registered nurses with the remaining 8.1% involving licensed practical nurses, licensed nurses or licensed vocational nurses.

This suggests LPNs and LVNs “tend to have fewer and less severe claims than do RNs, possibly due to the RNs' higher level of responsibility and the greater probability that RNs work in an acute care setting,” says the report.

Risk control recommendations listed in the report were:

• Nurses should know and comply with the stated scope of their practice.

• Nurses should follow documentation standards established by professional nursing organizations and comply with their employers' standards.

• Nurses should develop professional written and spoken communication skills.

• Nurses should emphasize ongoing patient assessment and monitoring.

• Nurses should maintain relevant clinical competencies.

& bull; Nurses should invoke the chain of command when necessary.

NSO President Michael Loughran said in a statement, “It is our intention that by sharing this information, identifying the causes of loss, and incorporating risk management recommendations into the document, we can help enhance the risk management knowledge of the nursing community.”

Copies of the report, “Understanding Nurse Liability, 2006-2010: A Three-Part Approach,” can be found at www.nso.com/nurseclaimreport2011. For hard copies, contact David Griffiths, senior vp at Aon Affinity, at david.griffiths@aon.com.