Protection from being sued No strategy guarantees complete protection from being sued for malpractice. Unfortunately, patients or families may file lawsuits against nurses and other healthcare professionals for reasons that have nothing to do with the quality of care received (Wacko Guido, 2020). Patients may be unhappy about a diagnosis or the outcome of a procedure. They may believe they were not treated with respect, or they may express anger over the death of a loved one even though standards of care were upheld. Unfortunately, some people are simply looking for an opportunity to obtain money regardless of the care received. Although none of these reasons is the result of a nurse’s failure to adhere to appropriate standards of care, lawsuits can still be filed. Remember, however, that for the plaintiff to win a malpractice action, the four elements of malpractice must be proven (Wacko Guido, 2020). Nursing consideration: A malpractice lawsuit has what is called an applicable statute of limitations. This means that a legal action must be filed against all defendants within a specific period of time from the time the allegedly negligent incident occurred (Wacko Guido, 2020). Sometimes, to avoid discovering that the statute of limitations has expired, and certain nurses and other healthcare professionals were not included as defendants in the lawsuit, the patient’s/plaintiff’s attorney may include as defendants “anyone and everyone” who may have been in any way involved in the client’s care concerning the events leading to the alleged harm. After investigation, nurses and others not actually involved may be eliminated from the lawsuit (Wacko Guido, 2020). Is there anything nurses can do to reduce the chances of being named in a malpractice action? Here are some suggestions (Wacko Guido, 2020): ● Practice only within the framework of their NPA and the scope and standards of their practice. ● Remain competent by attending in-services and continuing education activities. ● Become active in professional organizations. ● Identify their strengths and weaknesses. Work to enhance strengths and reduce weaknesses. Do not accept assignments if they feel they are not competent to perform them. ● Use all equipment safely and appropriately. If a nurse is unsure about the operation of a piece of equipment, they should seek assistance. ● Document all patient care activities and communications relating to patient care. ● Know how to use the chain of command to seek clarity or report situations that compromise patient care, and do not hesitate to do so. ● Interact in an objective, honest, and respectful manner with patients, families, and colleagues. Nursing consideration: The most effective way for nurses to protect themselves from facing a malpractice lawsuit is to know and practice according to the NPA and standards for their levels of nursing practice and degree of specialization. This means that they must know the standards and NPA of the state or states within which they practice. They must also know the scope of practice standards as established by other recognized authorities such as relevant specialty organizations and the healthcare organization in which they practice (Wacko Guido, 2020). The National Council of State Boards of Nursing does provide a checklist to enhance patient safety and minimize a nurse’s liability for exposure (NCSBN, 2018c).
2. Decline to perform a requested service that is outside legal scope of practice and immediately notify supervisor or the director of nursing. 3. Contact the risk management or legal department regarding patient and practice issues, if necessary. 4. Contact the board of nursing and request an opinion or position statement on nursing practice issues. 5. Use the chain of command or the legal department regarding patient care or practice issues. 6. Evaluate every patient for risk of falling utilizing a fall assessment tool that considers the following factors, among others: Previous fall history and associated injury, gait and balance disturbances, foot and leg problems, reduced vision, medical conditions and disabilities, cognitive impairment, bowel and bladder dysfunction, special toileting requirements, use of both prescription and over- the-counter medications, and need for mechanical and/or human assistance. 7. Evaluate environmental factors needed to reduce risks - whether working in a hospital, rehabilitation, long term care facility, or in a home setting. 8. Accurately document all falls; some of the documentation should include patient functional status before and after fall, any witnesses to the fall, any contributory concerns (wet floor), and mental state, along with other things. 9. Complete a patient drug history, including current prescription medications; over-the-counter drugs and supplements; alternative therapies; and alcohol, tobacco and illicit drug use. 10. Review allergy notations on medication profiles before administering any medications. 11. Review laboratory values and diagnostic reports before administering medications and make practitioners aware of any abnormalities. 12. Utilize machine-readable barcoding to check patient identity and drug data before administration of drugs or, if this is not possible, verify patient identity using two patient identifiers (such as patient ID number and birthdate) from the original prescription. 13. Document simultaneously with medication administration to prevent critical gaps or oversights. 14. Accept verbal drug orders from practitioners only during emergencies or sterile procedures and, before transcribing the order, read it back to the prescriber and document the read-back for verification. 15. Follow procedures to prevent wrong dosages or concentrations of identified high-alert drugs (e.g., anti- coagulants, muscle relaxants, insulin, potassium chloride, opioids, adrenergic agents, dextrose solutions and chemotherapeutic agents). 16. Ensure that high-alert medications are always accompanied by standardized orders and/or computerized safe- dosing guidelines and are verified by two persons before administration. 17. Ensure that pediatric medications are accompanied by standardized orders and/or computerized dosing guidelines. 18. Follow employer’s guidelines for both adult and pediatric patients’ dosages, formulations, and concentrations of drugs. 19. Follow the employer’s policies and procedures to keep drugs with look-alike and sound-alike names separate (NCSBN, 2018c). Nursing consideration: Per report by the Nurses Service Organization (2020) the top defense matters in nursing litigation were 32.5% professional misconduct; 24.8% scope of practice, 9.7% documentation errors of omissions, 9.3% treatment and care; 8.8% patient’s rights and patient abuse; 6.2% medication administration (NSO, 2020).
Below are some of the points on the checklist: 1. Read nurse practice act at least annually.
Page 101
EliteLearning.com/Nursing
Book Code: ANCCUS2423
Powered by FlippingBook