Read the case study presented at the end of Chapter 10, which begins “The elderly patient resided at the nursing home for almost a year before she died

Question

Read the case study presented at the end of Chapter 10, which begins “The elderly patient resided at the nursing home for almost a year before she died at the hospital.”  Did the lack of documentation in the admitting nurse's assessment and notes affect the ultimate outcome of this case? Was there negligence on the part of the nursing staff in the care of this patient? What could the nurse have done differently to facilitate a different outcome in this case? How would you decide this case?  Using the sample professional liability insurance policy (Chapter 11 p. 191-192 Figure 11-1) locate the various provisions:  Limits of liability Declarations Deductibles Exclusions Reservation of rights Covered injuries Defense costs Coverage conditions and supplementary payments Did you have difficulty finding some of the sections?

Admin · Accepted Answer

Nurses are legally obliged to be competent, and to provide safe care by following appropriate guidelines and protocol to deliver safe care. In nursing practice, legal and ethical issues arise because of lack of the nurse’s understanding of the policy regulations that dictate and inform professional behavior. Carelessness coupled by stress overload can equally cause the nurse to compromise their moral obligation to the patient, leading to safety concerns (Azizian et al., 2021).  Because of too much work, a nurse may neglect some of their obligations or responsibilities, and as a result, cause harm to the patient. When a nurse causes injury to the patient because of negligence, they may lose their license, job or face malpractice suit. In certain cases, an insurance company may pay the injured patient if a nurse has professional liability policy. However, the idea of compensating the patient in this case can be intricate as presented in the case study in chapter 11.  It is important to examine the liability issues that occur in the nursing profession.  Chapter 10 Case Study Analysis  Whether the Lack of Documentation in Admitting Nurse’s Assessment and Notes affected the Outcome of the Case  Given the details of the case study, there is a perspective from which one can explain the reasons for the outcomes of the case. The events of the case played out as they did due to the inability of the nurse to recognize missed diagnosis. With undocumented missed diagnosis, the nurse would not have managed to influence the outcomes of the case.  The nurse was unprofessional in terms of how they handled the issue, and this could be because they lacked the experience of recognizing the patient’s needs including the diagnosis (Mello et al., 2020). Had the nurse had adequate experience, they would have placed the patient in a safer bed to minimize their risk of developing pressure ulcers.  Evidence of Negligence on the Part of the Nursing Staff in the Care of the Patient  The nursing staff neglected their duty to prevent the patient from developing the pressure ulcers by failing to perform comprehensive assessment of the patient. Had they comprehensively assessed the patient, they would have helped avert the problem. One of the defining features of this assessment is that it involves gathering pertinent patient’s information including their risks of developing serious health disorders (Dahlawi et al., 2021). Because the nurse’s failure to review the patient’s health, they failed to notice the possibility of the patient developing pressure ulcers.  What the Nurse could have Done Differently to Facilitate a Different Outcome in the Case  To facilitate different outcomes, the nurse should have documented the diagnosis information. With the information documented, the clinicians working with the patient would have been able to access it, resulting to effective management of the patient’s health. This information is equally important in the sense that it communicates the patient’s data including needs so that providers rely on it to make informed decisions about treatment (Kearney, 2022). To better document clinical information, a nurse should perform the task objectively, presenting real information in a professional manner (Vaismoradi et al., 2021). It is equally imperative that they use the correct grammar to avoid problems that may arise because of miscommunication.  How I would decide the Case  I would hold the nurse liable for negligence because their mistake contributed to the negative health outcomes for the patient. When it comes to maintain health care safety and preventing injuries, the nurse plays various roles including adhering to the protocol that guide clinical decisions. The nurse also carefully assesses the patient, identifying any issues that may develop into major health problems.  The nurse equally plans for the care, monitoring the implementation of the plan to ensure it benefits the patient (Cheluvappa & Selvendran, 2020). Because of the nurse’s failure to observe these guidelines, the patient developed complications. Considering these factors, therefore, I would rule against the nurse.  Professional Liability Insurance Policy  Whether I had Difficulty Finding Some of the Sections  While going through the text, I experienced difficulty finding some of the sections. This could be attributed to the lack of clear headings that can direct one to the right information. Besides the use of headings, using sequence provides an effective way of presenting information, making it easier for one to identify it.  Whether I would Consider Purchasing the Policy for my Own Liability Coverage  When making decisions in terms of the type of policy to purchase, I would purchase the policy to cover a liability because it is detailed enough. The policy has a coverage period, which according to the policy, is a year. Although this is enough time for such a policy, the client can renew it. The policy equally includes sufficient information pertaining to the client’s role when it comes to responding to an event.  In case of occurrence of an event, the client has to write to the program administrator, notifying them of the event while they provide adequate details (Moukalled & Elhaj, 2021). As described in the policy, the policy holder should cooperate by sharing evidence and other pertinent information that can help with processing the claim.  The policy also has limit of the amount that the claimant is eligible to receive in the events that they experience bad incident. Other features that I equally find important in the policy include the agreement and exclusion. With details pertaining to exclusion including the limits of liability, it is possible to identify only what the insurer is ready to pay. This is also important because it helps one make the right decisions (Miziara & Miziara, 2022). Therefore, I would consider the policy to cover a professional liability.  Chapter 11 Case Study Analysis  The Provisions of Insurance Policy I would consider to determine if an Insurance Firm Should Pay Such a Claim  When determining whether an insurance firm should settle the claim, I would consider certain provisions. Part of the provisions I would consider in this case is the insured persons. I would particularly want to know if the administrator is in the list of the insured individuals because an insurer can only pay if the nursing home insured the administrator. The other provision is the coverage period including the date that the cover starts.  If the insurance policy indicates that the client will be eligible for compensation if they experience unfavorable event, three months after filling the policy, the insurer will pay only after the stipulated duration (Podgorica et al., 2021). Another important point to consider when determining the provisions is the maximum or lowest amount the insuring firm can pay as a settlement for liability. It is equally important to determine the exclusions. In the case of the organization, this could be what the insurer does not cover.  What the Limits of Liability Would be for Such a Claim  For the claim described in the case study, the ideal limit of liability would be $1,100,000. Considering that the administrator’s refusal to turn on the air-conditioner caused four patients to lose their lives, the insurer will have to pay $1,100,000 because the deaths resulted from a single mistake.  Whether the Nursing Home Insurance Company is Correct in saying that it is a Professional Judgment Issue    The insurance firm for the nursing home is wrong when it says that the issue is a professional judgment problem. Given the details presented in the case, the administrator’s decision led to the death of the seniors. When an insurance firm covers a client under professional liability, it has the obligation to compensate the people affected by the client’s wrong judgment or decisions (Guido, 2020). The inability of the administrator to make the right judgment, therefore, amounts to a professional liability. Therefore, the complainant is eligible for compensation based on the judgment.  The Insurance Company that Should Pay the Court-Ordered Judgment  In case the administrator has a cover, her insurance company would be responsible of paying the court-ordered judgment. In this case, the administrator would be the insurer’s client, but not the nursing home.  How I Would Decide the Case  When ruling over the case, I would rule in favor of the nursing home because it insured itself against an unfortunate event stemming from employees’ decisions that may cause injury to the patient.  Conclusion  In conclusion, professional nursing is associated with a wide range of liability issues such as failure to follow appropriate guideline when handling patient cases, and engaging in malpractice. To avoid the legal issues linked to negligence and malpractice in professional nursing, an organization needs to identify the terms of the policy including the different provisions (Guido, 2020). Understanding these provisions is important because it can help one avoid the complications linked to the professional liability.  A nurse should equally engage in judicious judgment when making clinical decisions because this can help them avoid the legal issues. Undelivered services coupled by mistakes are some of the factors that can contribute to liability.  When a healthcare organization wants to engage in a professional liability agreement with an insurer, it is important that they review the insurer’s insurance policy. By reviewing the policy, they can make better decisions by choosing the right policy.  References  Azizian, J., Dalai, C., Adams, M. A., & Tabibian, J. H. (2021). Medical professional liability risk and mitigation: an overview for early-career gastroenterologists. The new gastoenterologist, 2021, https://www.mdedge.com/gihepnews/article/236858/practice-management/medical-professional-liability-risk-and-mitigation?channel=46655.  Cheluvappa, R., & Selvendran, S. (2020). Medical negligence - Key cases and application of legislation. Annals of medicine and surgery (2012), 57, 205–211. https://doi.org/10.1016/j.amsu.2020.07.017.  Dahlawi, S., Menezes, R. G., Khan, M. A., Waris, A., Saifullah, & Naseer, M. M. (2021). Medical negligence in healthcare organizations and its impact on patient safety and public health: a bibliometric study. F1000Research, 10, 174. https://doi.org/10.12688/f1000research.37448.1.  Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Prentice Hall. ISBN: 9780134701233.  Kearney, K. M. (2022). Risks of practicing without professional liability insurance. Nursing, 52(8), 51–54. https://doi.org/10.1097/01.NURSE.0000839820.29490.6e.  Mello, M. M., Frakes, M. D., Blumenkranz, E., & Studdert, D. M. (2020). Malpractice Liability and Health Care Quality: A Review. JAMA, 323(4), 352–366. https://doi.org/10.1001/jama.2019.21411.  Miziara, I. D., & Miziara, C. S. M. G. (2022). Medical errors, medical negligence and defensive medicine: A narrative review. Clinics (Sao Paulo, Brazil), 77, 100053. https://doi.org/10.1016/j.clinsp.2022.100053.  Moukalled, T., & Elhaj, A. (2021). Patient negligence in healthcare systems: Accountability model formulation. Health policy OPEN, 2, 100037. https://doi.org/10.1016/j.hpopen.2021.100037.  Podgorica, N., Pjetri, E., Müller, A. W., & Deufert, D. (2021). Identifying ethical and legal issues in elder care. Nursing ethics, 28(7-8), 1194–1209. https://doi.org/10.1177/0969733020981761.  Vaismoradi, M., Jordan, S., Logan, P. A., Amaniyan, S., & Glarcher, M. (2021). A Systematic Review of the Legal Considerations Surrounding Medicines Management. Medicina (Kaunas, Lithuania), 57(1), 65. https://doi.org/10.3390/medicina57010065.

[ANSWERED 2023] For this week assignment, write a 1500-word essay addressing each of the following points/questions. Read the case study presented at the end of Chapter 10, which begins

Written By: Dan Palmer, RN

Edited By: Ethan Green, MSN-FNP

For this week assignment, write a 1500-word essay addressing each of the following points/questions. Read the case study presented at the end of Chapter 10, which begins

Expert Answer and Explanation

Professional Liability Issues in Nursing

Chapter 10 Case Study Analysis

Professional Liability Insurance Policy

Chapter 11 Case Study Analysis

Conclusion

FAQs

Professional Liability Insurance Coverage

What is the difference between general liability and professional liability insurance?

Difference Between Coverage Conditions and Supplementary Payments

Quote

USD $10.99