Legal Risks of Nurses and 2 Discussion Questions
Description
Legal Risks of Nurses
Analyze the case of Mrs. Ard on page 215 of Legal Aspects of the textbook. Answer the following questions:
- What happened?
- Why did things go wrong?
- What were the relevant legal issues?
- How could the event have been prevented?
- What is your verdict?
CHANCE OF SURVIVAL DIMINISHED
On the afternoon of May 20, the patient, Mr. Ard, began feeling nauseous. He was in pain and had shortness of breath. Although his wife rang the call bell several times, it was not until sometime later that evening that someone responded and gave Ard medication for the nausea. The nausea continued to worsen. Mrs. Ard then noticed that her husband was having difficulty breathing. He was reeling from side to side in bed. Believing that her husband was dying, she continued to call for help. She estimated that she rang the call bell for 1.25 hours before anyone responded. A code was eventually called. Unfortunately, Mr. Ard did not survive the code. There was no documentation in the medical records, on May 20 between 5:30 P.M. and 6:45 P.M., that would indicate that any nurse or physician checked on Ards condition. This finding collaborated Mrs. Ards testimony regarding this time period.
A wrongful death action was brought against the hospital, and the district court granted judgment for Mrs. Ard. The hospital appealed.
Ms. Krebs, an expert in general nursing, stated that it should have been obvious to the nurses from the physicians progress notes that the patient was a high risk for aspiration. This problem was never addressed in the nurses care plan or in the nurses notes.
On May 20, Ards assigned nurse was Ms. Florscheim. Krebs stated that Florscheim did not perform a full assessment of the patients respiratory and lung status. There was nothing in the record indicating that she completed such an evaluation after he vomited. Krebs also testified that a nurse did not conduct a swallowing assessment at any time. Although Florscheim testified that she checked on the patient around 6:00 P.M. on May 20, there was no documentation in the medical record.
Ms. Farris, an expert in intensive care nursing, testified for the defense. She disagreed with Krebs that there was a breach of the standard of care. However, on cross-examination, she admitted that if a patient was in the type of distress described by Mrs. Ard and no nurse checked on him for 1.25 hours, then that would fall below the expected standard of care.1
WHAT IS YOUR VERDICT? (Pozgar 215-216)
Pozgar, George D.. Legal Aspects of Health Care Administration, 11th Edition. Jones & Bartlett Learning, 2011-01-27. <vbk:9781449643850#outline(9.1)>.
Discussion Question 1
Discuss how physician malpractice suits can be decreased. How can a
doctor be sued for malpractice? What current practices do doctors
perform in order to avoid law suits? What are the impacts of these
practices? How can one check for any malpractice suit against a doctor?
Discussion Question 2
Evaluate why prescribing, control, and administration of medications is a
major area of legal concern for health care providers. What is the
impact of medication errors to the patient and the health care provider?
Discuss ways doctors make mistakes in prescribing medication. What
kinds of errors do nurses make regarding the administration of
medications? Review the documentary Chasing Zero
and, in addition to conducting your own research, address the methods
or practices that you feel would be most effective in reducing
medication/prescribing errors.
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References:
Nursing Standards
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Clinical Guidelines
Guideline Adaption Committee. (2016). Clinical practice guidelines and principles of care for people with dementia. NHMRC Partnership Centre for Dealing with Cognitive and Related Function Decline in Older People. https://cdpc.sydney.edu.au/wp-content/uploads/2019/06/CDPC-Dementia-Guidelines_WEB.pdf
Living Guideline
Stroke Foundation. (2022). Australian and New Zealand living clinical guidelines for stroke management – chapter 1 of 8: Pre-hospital care. https://app.magicapp.org/#/guideline/NnV76E
Evidence-based practice
BMJ Best Practice
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JBI: Evidence summary
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JBI: Best practice information sheet
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Cochrane Database of Systematic Reviews
Srijithesh, P. R., Aghoram, R., Goel, A., & Dhanya, J. (2019). Positional therapy for obstructive sleep apnoea. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010990.pub2
Drug Information
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Colorado State University. (2011). Why assign WID tasks? http://wac.colostate.edu/intro/com6a1.cfm
Dartmouth Writing Program. (2005). Writing in the social sciences. http://www.dartmouth.edu/~writing/materials/student/soc_sciences/write.shtml
Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice? [Abstract]. Online Journal of Issues in Nursing, 13(1). http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Health-IT/StandardizedNursingLanguage.html
Wagner, D. (n.d.). Why writing matters in nursing. https://www.svsu.edu/nursing/programs/bsn/programrequirements/whywritingmatters/
Writing in nursing: Examples. (n.d.). http://www.technorhetoric.net/7.2/sectionone/inman/examples.html
Perth Children’s Hospital. (2022, April). Appendicitis [Emergency Department Guidelines]. Child and Adolescent Health Service. https://www.pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Appendicitis
Department of Health. (n.d.). Who is being active in Western Australia? https://ww2.health.wa.gov.au/Articles/U_Z/Who-is-being-active-in-Western-Australia
Donaldson, L. (Ed.). (2017, May 1). Healthier, fairer, safer: The global health journey 2007-2017. World Health Organisation. https://www.who.int/publications/i/item/9789241512367
NCBI Bookshelf
Rodriguez Ziccardi, M., Goyal, G., & Maani, C. V. (2020, August 10). Atrial flutter. In Statpearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540985/
Royal Perth Hospital. (2016). Procedural management: Pre and post (24-48 hours) NPS. Canvas. https://courses.ecu.edu.au
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