Preventing nursing malpractice claims is simple. If nurses practice within their nursing scope, they will avoid legal claims. Nurses are responsible for providing safe care to their patients without causing harm. Every year, the healthcare industry receives multiple personal injuries claims against healthcare facilities and healthcare professionals. Nursing malpractice occurs when a nurse deviates from the standard of practice or provides substandard care that leads to patient harm, injuries, or damages.
Nurses are not exempt from personal injury claims. Thus, to avoid legal claims, nurses should review their Position Description or Statement of Work. Furthermore, nurses should maintain all licenses and certifications. In addition, nurses must practice within their nursing scope and receive training and orientation at the healthcare facility. You can visit the Maryland Nurse Practice Act for additional information.
Nurses must follow their employer’s Standards Operating Policies – SOP. Besides, nurses must assess and monitor their patients and communicate changes in patient status to the primary medical provider. It is important for nurses to use each medical equipment according to the manufacturer’s guidelines. In addition, they must document patient care and advocate for all their patients.
Review The Position Description To Prevent Nursing Malpractice Claims
Position Description – PD: A position description is similar to a job contract. For example, it includes the tasks that you will be responsible for. It also includes the type of job you will perform and your authority level. In addition, the PD also describes the skills that are required to perform the job and the settings or environments that you will work in. For example, a medical-surgical nurse will need to be able to assess patients independently and implement the prescribed treatment plan.
Maintaining Current Licenses and Certifications: It is a Joint Commission and state requirement for nurses to maintain a license in order to provide care to patients. Some additional certifications might be required. For instance, some employers require nurses to have First Aid, Cardio-Pulmonary Resuscitation, Advanced Life Support. Thus, maintaining current licensure can prevent nursing malpractice claims.
The Maryland Board of Nursing offers nursing licenses every two years. Nurses are responsible for renewing their licenses on time and for following their employer’s deadline. For instance, Some healthcare agencies require license renewal thirty days before the expiration date. In that instance, the employer’s date is thirty days ahead of the state.
Some healthcare facilities prefer certification in specialty units. For example, the Intensive Care Unit, Main Operating Room, Pediatrics, Cardiac Unit, Oncology, Labor & Delivery, Mental Health, Emergency Department and other clinical settings often require certifications.
Maintain Current Staff Training And Orientation
Why do employers ask for certification? The certification often validates additional training in the clinical specialty area besides basic knowledge. It also reinforces the nurse’s dedication to continuing education. Thus, nurses have to comply with all certification requirements as established by their organization to avoid legal nursing claims.
Healthcare employers must comply with training and orientation per state requirements. Please visit CMS for more information.
The employer must orient nurses during the probationary period of employment (zero to two years). The healthcare employer should also provide workspace orientation to all new employees. Some of the examples are fire hazards, evacuation process, department configuration, environmental hazards, emergency procedures, Information Technology systems, phone operations, and documentation software. Employees should never start working unless they complete workspace orientation.
Nursing Orientation: The employer should review its policies with all newly hired nurses during orientation. For example, nursing care for combative patients, blood transfusion protocol, code activation, Patient Control Analgesia, elopement, admission assessments, the discharge process, and more.
The employer must keep records of all employees’ training and establish guidelines for periodic training. A nursing license does not automatically enable a nurse to practice certain skills. For instance, some facilities train nurses to remove mediport while others only train nurses in specialty units to perform that task.
Practice Within Your Scope To Prevent Nursing Malpractice Claims
It is essential for nurses to obtain the nursing scope of practice in the state that they are licensed to perform. For example, some state approves Registered Nurses to pronounce deaths. However, other states do not. If the position description mentions that a nurse will perform that task, the nurse must discuss his or her license restrictions with the nursing leadership.
If nurses fail to follow their scope of practice, they are placing themselves at the risk for personal injury claims. Furthermore, the scope of practice guides the professional care and consultation that nurses can provide to patients. For example, some facilities train nurses to remove the Central line- PICC line.
If a provider asks a nurse to assist with a procedure, the nurse should refrain from acting as the provider. For example, nurses cannot introduce a needle in a patient’s spine to perform fluid aspiration unless they are Nurse Practitioners. Besides, nurses do not remove invasive surgical drains unless the healthcare facilities or the Doctor’s office provide the required training. Following the employer’s guidelines, will protect nurses against personal injury claims.
Follow The Employer’s Guidelines To Avoid Legal Claims
Nurses can avoid legal claims by following their employer’s policies. Thus, nursing leadership must establish standards to guide nursing practice in the facility. Therefore, nurses are expected to follow the guidelines to promote safe patient care. If a nursing policy prevents nurses from removing a Central Line, nurses in that facility should not remove it regardless of previous clinical experiences.
Policies support a company’s mission and vision. Thus, nurses should educate themselves about approved policies to avoid deviation from standards. In addition, nurses place their profession at risk for litigation claims when they divert from organizational standards. Policies include step by step instructions about the completion of certain tasks. Therefore, nurses should review the policies that affect their department and their profession before providing care to their patients.
Obtain Professional Liability Insurance
Legal Claims – Complaint: It is a misperception that nurses can not be sued. If the injuries or damages claims are caused by nursing care or individual performance, a civil suit can be filed against that nurse. Please understand that your employer does not have to provide legal assistance to you. I know many nurses often ask if they should purchase professional liability insurance? The answer is yes they should obtain coverage to protect their nursing licenses.
Nurses are responsible licensed professionals that are trained to provide care to complex patients across all care settings. Thus, they are accountable for the care they provide. If a nurse makes a poor clinical judgment and inadvertently causes harm to a patient, the nurse risks a personal injury lawsuit.
Avoid Nursing Malpractice Claims By Following The Nursing Standards
Assess and monitor your patients: It is a requirement for nurses to assess every patient within the first few hours of admission. Most healthcare facilities enable nurses to complete the assessment within twenty- four hours. Thus, if a nurse fails to assess a patient in the first twenty-four hours of admission, it is considered a deviation from established standards.
All abnormal clinical findings following twenty-four hours of admission are classified as facility acquired conditions, and the agency will not receive any payment for treatment. Thus, completing the nursing assessment on time can prevent nursing malpractice lawsuits.
The nursing assessment should include a system assessment from head to toe and should consist of proper skin inspection. Nurses should also review past medical history and clinical symptoms. Besides, nurses should complete a medication review and acknowledge new admission orders. Nurses will clarify ambiguous orders with the admitting Doctor. It is essential to follow the employer’s policy about clinical documentation.
Complete Clinical Documentation
Clinical Documentation: Nurses must document a series of clinical events and care that they provide to their patients every shift per the employer’s protocol. For instance, nurses document the patients’ conditions, subjective and objective data in the patients’ records. The Center for Medicare and Medicaid Services requires healthcare facilities to define their documentation requirement.
The documentation policy should include who to document on, what to include, how to complete nursing documentation, when to document and why nurses must comply with clinical documentation. Thus, compliance with the clinical documentation can prevent nursing malpractice claims.
Communicate Effectively To Prevent Nursing Malpractice Claims
Failure to communicate is one of the main causes of preventable medical errors. It is imperative for nurses to communicate sudden changes in the patients’ status to the primary provider. The communication must occur within an established time frame. For instance, most facilities require nurses to report critical laboratory results within one hour. If the nurses are unable to reach the provider, they should follow the chain of command.
Nurses must report refusal of care and treatment to the primary provider as soon as the patients verbalize it. For instance, if a patient refuses diagnostic imaging, the nurses must inform the primary provider. The diagnostic imaging often determines hospital length of stay and treatment plan. The patient’s diagnostics imaging was delayed, and a diagnosis was not established on time.
The treatment plan was also not appropriate for the patient due to a delay in imaging. If the patient experiences a delay in diagnosis with a small bowel obstruction, a legal team can identify multiple gaps in the communication systems. The legal team can file a medical malpractice lawsuit due to failure to communicate and delay in treatment. The delay in diagnostics imaging might contribute to poor patient outcomes and other damages.
Use Equipment Safely
It is imperative for nurses to receive training on all types of equipment that they will use at work. The healthcare employer is responsible to develop training objectives for nursing staff according to the manufacturer’s guidelines. Thus, if the nurses did not receive training at their current facility, they should not use the equipment during patient care. Nurses risk personal injury claims in that case.
Some equipment types require more than one operator. Therefore, nurses should ensure two staff members operate those types of equipment. For instance, the manual lift also known as Hoyer lift requires two operators when transferring patients. When nurses deviate from safety standards, the patients can file personal injury and product liability claims against the healthcare agency and the nurse.
Follow Equipment Management Process
A failure to follow the employer’s protocol and manufacturer’s guidelines increases the risks of adverse clinical events. Nurses are also responsible for verifying that the equipment has been serviced by Biomedical technicians or vendors before using the equipment. The training objectives for equipment management should include instructions about a flagging process. For example, the nursing staff will place a tag on a piece of defective equipment and include detailed information about the equipment.
Service tags or stickers often include the last maintenance date and future service date. Defective tags vary by organizations, but nurses can apply tags on defective equipment for maintenance. When nurses identify defective equipment during patient care, the nurses will tag or label the equipment, remove it from the patient care area, inform BioMed or the vendor and complete an incident report.
Advocate For The Patients
Nurses are the patients’ best advocates because they provide more direct care hours to the patients in comparison with other clinical services. Thus, nurses are responsible to share their clinical assessment findings with the interdisciplinary team and express concerns when necessary about the treatment plan and the patients’ response.
Nurses are also responsible for protecting their patients against all types of abuse. They must report suspected abuse immediately to the primary provider, social worker, local law enforcement and nursing leadership. Thus, Nurses should monitor the patients for signs and symptoms of physical abuse, mental, emotional, sexual and financial abuse. In addition, it is a state and a federal requirement for healthcare professionals to report suspected patient abuse.
Healthcare facilities should comply with state abuse training recommendations to ensure that nurses are competent. The training will enable nurses to identify signs and symptoms of different types of abuse and to address concerns with team members. When in doubt, nurses should express their clinical opinions to eliminate preventable medical errors. If nurses follow these recommendations, they will prevent nursing malpractice claims.
It is very prudent for nurses to prevent nursing malpractice claims when providing care to patients. Nurses should avoid legal claims by following their scope of practice and the healthcare employer’s guidelines. The standards process will enable nurses to provide safe care to patients. When nurses fail to collaborate with the healthcare team, there is a higher chance for communication errors to occur.
A legal team can file malpractice lawsuits against the nurse for placing the patient at risk and for causing personal injury. It is highly recommended for nurses to purchase professional liability insurance. It is a myth that employers will cover lawsuits filed against their nurses. I have professional liability insurance that covers errors by omission.
lastly, nurses should communicate effectively with team members, assess and monitor each patient in the first twenty-four hours. Furthermore, nurses must document a series of patient events, advocate for every patient. Nurses need to understand that they should follow their scope of practice all the time. Moreover, nurses must complete appropriate training to prevent nursing malpractice lawsuits. Please visit nursesophieconsulting to request legal nurse consultation. You can use the checklist as a guide to preventing malpractice claims.
Nurse Sophie has been a registered nurse for over a decade. I have a Master's degree in nursing, and my clinical experiences include staff nurse, clinical nurse supervisor, and manager, and most recently, nurse consultant in Patient Safety and legal nursing. I was always passionate about system operations and practice standards.
I have completed over 2000 hours of medical chart reviews. I am an expert in clinical investigations, and I also develop event timelines. I can assist the legal team with the Discovery process: Deposition, Interrogatories questionnaire, event timelines, locate expert witnesses, and more. I provide and formulate clinical opinions based on the investigative summary.
Nurse Sophie, MSN, RN, LNC
Legal Nurse Consultant
Patient Safety Specialist
Email: [email protected]