Negligence and malpractice lawsuits constitute the majority of legal quarries directed at the healthcare systems around the world. Each year sees more than 550 closed claims in the US alone, which ends up in over 90 million dollars a year paid over the 5-year-long period (“More Nurses,” 2016). The majority of these claims are directed towards registered nurses (89%), followed by licensed practical nurses and licensed vocational nurses (11.5%) (“More Nurses,” 2016). Negligence and malpractice present not only significant financial risks to the hospital in question but also a serious danger to the patients’ health and wellbeing. The purpose of this paper is to provide a set of negligence and malpractice guidelines for medical employees.
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Negligence, as defined by the joint commission on Accreditation of Healthcare Organizations (JCAHO), is the provision of a subpar standard of care in comparison to the delivery by a prudent and careful person under similar circumstances (Croke, 2003). If a nurse performs worse than an average person should, regardless of the outcome, it is classified as an act of negligence. Malpractice, on the other hand, is defined as an act of improper or unethical conduct, often performed with an unreasonable lack of skill by an individual who is supposed to be able to perform better (Croke, 2003). This type of infraction can be applied not only to nurses but to other medical and supporting personnel, such as physicians, dentists, lawyers, health managers, and others. Malpractice lawsuits allow for paying damages, thus eligible for being brought into court.
Examples of Negligence and Malpractice
Failure to Follow Established Standards of Care
All nurses are expected to follow two established sets of standards for care, one of them being the federal standards and the other being the hospital’s own processes and procedures, which are often made to increase the quality of the delivered services (Pozgar, 2020). Breaching one of these standards often constitutes the violation of the other, as the two are tightly interwoven. An example of a malpractice lawsuit associated with standards of care would be Hall v. Arthur (1998), which held a hospital liable for the damages for a nurse’s breach of standard during an anterior cervical discectomy and fusion. The violation revolved around the use of a ceramic substance (Orthoblock) to replace a part of Mr. Hall’s spine during the surgery, which resulted in prolonged back difficulties during the next four months, after which a second operation was required to remove the Orthoblock and implant the part of the patient’s spine back (Croke, 2003). Negligence, in this scenario, was the use of an unusual product instead of following the standard procedure.
Failure to Use Tools and Equipment Appropriately
Modern medical treatments are often provided with the use of equipment, which, if used improperly, could lead to damage or even death. The case of Chin v. St. Barnabas Medical Center of 1984 features a situation where a 45-year old woman died as a result of a massive air embolism during a diagnostic hysteroscopy (Croke, 2003). The court discovered that the embolism appeared due to an operating mistake in managing the equipment, which was due to the lack of experience and credentials in nurses performing the operation. All nurses except for the scrub nurse were ordered to pay 2,000,000 dollars in damages, with 35% of that sum paid by the hospital (Croke, 2003). This case also demonstrates how malpractice while manning equipment could lead to severe complications in patients.
With nurses being required to manage an increasing amount of paperwork, inappropriate documentation often becomes a source of negligence and malpractice. Pellerin v. Humedicenters features a case where a failure to document the administration of medicine coincided with subpar performance. (Croke, 2003) An ED nurse administered Demerol and Vistaril to a patient, resulting in inflation at the point of injection, followed by cutaneous gluteal neuropathy. The failure to document the site and mode of injection by the nurse resulted in the jury favoring the plaintiff and affording 90,000 dollars in compensation.
Ensuring the highest possible standard of care remains the hospital’s top priority. Failure to do so would result in endangering the patients, complicating the existing situation, and possibly facing financial charges. The following set of guidelines will help reduce the chances of negligence and malpractice if followed (Pozgar, 2020):
- Maintain honesty and respectful relationships with patients and fellow staff;
- Maintain high standards of personal knowledge and skills by self-improving and attending courses;
- Know and incorporate legal principles into your day-to-day routine;
- Know your limits: do not accept an assignment you do not feel competent enough to perform;
- Keep all appropriate documentation, as in case of an incident; it can be used to determine the root of the issue.
By following these simple guidelines, nurses, physicians, and doctors would ensure the safety of their patients while reducing the chances of wittingly or unwittingly conducting acts of negligence or malpractice. Standards and regulations were developed in order to ensure uniformity and high quality of care.
Croke, E. I. (2003). Nurses, negligence, and malpractice. American Journal of Nursing, 103(9), 54-63.
Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). New York, NY: Jones & Bartlett Learning.