Module 4.04 LIABILITY

Social Factors (Uncontrollable)

- Health care being viewed as business - Impersonal treatment - High costs lead to people looking for large settlements

Suit-prone nurses (Controllable)

- Insensitive to complaints - Doesn't identify/meet patients' emotional needs - Complaining about work conditions or organizations

Consequences of error (Controllable)

- Prolonged hospitalization - Disability - Death

Patient personality (Uncontrollable)

- Some patients are more inclined to bring suit than others - Level of adherence and cooperation varies based on patient experience or personality - Some patients may cope with anxiety or fear by bringing suit

A nurse is preparing a patient for surgery. As the nurse completes the preoperative checklist, which action will decrease the risk of malpractice/liability?

Ensure informed consent has been completed and is in the chart. Reasonable actions and judgments include being competent in the area of current practice, securing help for situations one is unqualified to manage, and fulfilling professional duties as a nurse.

The new oncology nurse is getting ready to complete orientation. Which action will decrease the risk of liability for criminal or civil charges?

Review the nurse practice act. Reasonable actions and judgments for the new nurse include being competent in the area of current practice, securing help for situations an individual is unqualified to manage, and fulfilling professional duties as a nurse.

When providing the oncoming shift with change of shift report, the use of which type of nursing communication handoff may decrease the nurse's liability risk?

SBAR—situation, background information, assessment, recommendations SBAR communication provides a succinct, detailed form of communication between health care professionals. Using SBAR may decrease the nurse's liability risk. Standardization of interprofessional health care team communication eliminates oversights related to effective sharing of patient information and conflicts that may arise while providing patient care.

A patient was admitted to the hospital for a routine hysterectomy, and informs the nurse, 'I think I'd like a do-not-resuscitate [DNR] order.' The nurse obtains the proper paperwork and, without explaining the concept of DNR to the patient, asks the patient to sign the consent forms, then obtains the DNR order from the primary care provider. The patient thanks the nurse and states, 'Good. I want to be sure that I am not placed on any artificial machine to keep me breathing.' The nurse then leaves the room and attends to another patient. Did the nurse violate any laws or regulations, making her liable?

Yes The nurse should assist the patient in making an informed decision about the DNR, which includes explaining the concept, details, and implications of having a signed DNR. The nurse in this scenario did not explain the concept of DNR prior to the patient signing the consent form, thus making the nurse liable.

A nurse has been counseled many times due to incomplete nursing documentation. The nurse's assessments and notes are often incomplete or inaccurate. This places the nurse at a higher risk of:

liability. Nurses can never expect to contribute significantly to health care in its assessment, planning, implementation, and evaluation aspects if they do whatever they do in a mediocre manner. When nurses deviate from approved policies, procedures, or standards, they are at increased risk of being accused of malpractice or negligence.

True or false: Unclear or incomplete orders from physicians do not affect your liability, only the ordering physician's own liability.

FALSE This statement is false. Liability is the responsibility of one person or an entity to another person or entity. Therefore, unclear or incomplete orders will be the nurse's liability as well. Controllable and uncontrollable factors are elements of determining liability, and it is within a nurse's control to clarify any unclear or incomplete orders before continuing with a procedure.

True or false: If your actions lead to patient disability or death, you are liable.

FALSE This statement is false. The nurse will not be liable for client disability or death unless negligence can be proven. For that to occur, four elements must be present: proof that you owe a person care, not giving the care that any other nurse would in that situation, a connection between care and harm, and an actual result of injury.

Which of these is not a factor that makes a nurse prone to being sued?

Documenting interactions Documentation of care that is delivered serves as legal evidence in the nurse's defense when legal action is taken against a nurse. Meticulous documentation of events enables the nurse to present a highly professional image and serves as one of the best defense resources during legal actions.

What type of professional behavior would increase a nurse's liability potential?

Does not consult hospital policy and procedure when performing nursing procedures When nurses deviate from approved policies, procedures, or standards, they are at increased risk of being accused of malpractice or negligence.

The nurse assists a patient in completing paperwork for a DNR without explaining the forms to the patient. What should have been done to prevent liability in this case? Select all that apply.

Fully explain to the patient the concept of DNR vs. advanced directive, Obtain informed consent from the patient To prevent liability, the nurse should allow the client to make an informed decision. As such, the nurse should have explained the concepts of DNR and advanced directive to the patient.