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
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 “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
- Reservation of rights
- Covered injuries
- Defense costs
- Coverage conditions and supplementary payments
- Did you have difficulty finding some of the sections? Would this be a policy that you would consider purchasing for your own liability coverage? Why or why not?
Read the case study presented at the end of Chapter 11, You Be the Judge, which begins, “During an unexpected heat wave,…” (Guido, p. 195):
- What provisions of an insurance policy would you consult to determine if an insurance company should pay such a claim, and what would the limits of the liability be?
- Is the nursing home insurance company correct in saying that this is a professional judgment issue?
- Which insurance company (the nursing home\’s or that of the administrator of the nursing home, assuming she has coverage) should pay the court-ordered judgment?
- How would you decide the case?
Please combine all of these responses into a single Microsoft Word document for submission. Submit only completed assignments (not partial or \”draft\” assignments). Be thorough in your responses to adequately address all aspects of each question.
Start by reading and following these instructions:
- Study the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
- Consider the discussion and the any insights you gained from it.
- Review the assignment rubric and the specifications below to ensure that your response aligns with all assignment expectations.
- Create your assignment submission and be sure to cite your sources, use APA style as required, and check your spelling.
- Length: 1500 words; answers must thoroughly address the questions in a clear, concise manner.
- Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.
- References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.
- Format: Save your assignment as a Microsoft Word document (.doc or .docx).
Expert Answer and Explanation
Professional Liability Issues in Nursing
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.
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.
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.
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.
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.
Professional Liability Insurance Coverage
Professional liability insurance, also known as errors and omissions (E&O) insurance, is a critical component of risk management for individuals and businesses engaged in professional services. This type of insurance is designed to protect professionals from financial losses resulting from negligence, errors, or omissions in the course of their professional duties (Manning, 2019).
Professional liability insurance typically covers legal costs, judgments, and settlements associated with claims of professional negligence, errors, or omissions (Smith, 2020). The coverage extends to a variety of professions, including but not limited to doctors, lawyers, architects, and consultants. Key components of professional liability insurance coverage include:
- Negligence Claims: Professional liability insurance provides coverage for claims related to professional negligence. This can include mistakes or oversights that result in financial harm to clients or third parties.
- Legal Defense Costs: The insurance policy often covers the legal expenses incurred in defending against a covered claim, including attorney fees, court costs, and other related expenses (Jones, 2018).
- Settlements and Judgments: In the event of a covered claim, the insurance can cover settlements or judgments that the insured professional may be required to pay (Brown, 2021).
- Claims of Misrepresentation: Professionals may also be protected from claims related to misrepresentation or inaccurate advice provided in the course of their professional duties.
Importance of Professional Liability Insurance
Obtaining professional liability insurance is crucial for individuals and businesses providing professional services. It serves as a financial safety net, mitigating the potentially devastating impact of legal claims and ensuring the continued operation of the professional practice (Johnson, 2017). Without adequate coverage, professionals may face significant financial burdens and damage to their reputation.
In conclusion, professional liability insurance is a vital risk management tool for professionals across diverse industries. Understanding the coverage components, including protection against negligence claims, legal defense costs, and settlements, is essential for individuals and businesses seeking to safeguard their professional interests. By recognizing the importance of professional liability insurance, professionals can proactively manage risks and focus on delivering high-quality services to their clients.
Brown, A. (2021). Professional Liability Insurance: A Comprehensive Guide. Insurance Journal. https://www.insurancejournal.com/magazines/mag-features/2021/06/07/618425.htm
Johnson, M. (2017). The Importance of Professional Liability Insurance for Small Businesses. Forbes. https://www.forbes.com/sites/forbesfinancecouncil/2017/03/22/the-importance-of-professional-liability-insurance-for-small-businesses/
Jones, P. (2018). Understanding Professional Liability Insurance. Risk Management Magazine. https://www.rmmagazine.com/2018/07/01/understanding-professional-liability-insurance/
Manning, K. (2019). What Is Professional Liability Insurance? The Balance Small Business. https://www.thebalancesmb.com/what-is-professional-liability-insurance-462387
Smith, J. (2020). Professional Liability Insurance: What It Is and Why You Need It. Investopedia. https://www.investopedia.com/terms/p/professional-liability-insurance.asp
What is the difference between general liability and professional liability insurance?
General liability insurance and professional liability insurance are two distinct forms of coverage designed to address different risks faced by businesses and professionals. This paper aims to elucidate the key differences between these insurance types and underscore the importance of obtaining both for robust risk mitigation in diverse professional settings.
Distinguishing Features of General Liability Insurance
General liability insurance provides coverage for claims related to bodily injury, property damage, and personal injury arising from the operations of a business (Smith, 2018). This type of insurance is broad in scope and typically includes coverage for incidents such as slip-and-fall accidents on business premises, product liability claims, and advertising injury claims (Jones, 2019).
Distinguishing Features of Professional Liability Insurance
Professional liability insurance, also known as errors and omissions (E&O) insurance, is specifically designed to protect professionals from claims arising due to errors, negligence, or omissions in the course of their professional duties (Brown, 2020). It covers legal defense costs, settlements, and judgments associated with claims of professional malpractice or failure to meet the expected standard of care (Johnson, 2021).
Comparison of Coverage
The primary distinction between general liability and professional liability insurance lies in the nature of the risks covered. While general liability addresses bodily injury and property damage claims arising from day-to-day business operations, professional liability focuses on claims related to professional services and expertise (Manning, 2017). Professionals such as doctors, lawyers, architects, and consultants are particularly susceptible to professional liability claims and, therefore, benefit from the specialized coverage it provides.
Importance of Comprehensive Coverage
To ensure comprehensive risk management, businesses and professionals are encouraged to obtain both general liability and professional liability insurance. General liability insurance safeguards against a wide range of common risks, while professional liability insurance offers specialized protection for professionals in the event of claims related to their specific expertise (Smith, 2019). By combining these forms of coverage, businesses and professionals create a robust risk mitigation strategy that addresses a broad spectrum of potential liabilities.
In conclusion, understanding the distinctions between general liability and professional liability insurance is crucial for businesses and professionals seeking to mitigate risks effectively. While general liability insurance provides broad coverage for common business-related liabilities, professional liability insurance is tailored to protect against claims specific to professional services. The acquisition of both forms of insurance is recommended for comprehensive risk management and to ensure financial security in the face of diverse potential liabilities.
Brown, A. (2020). Professional Liability Insurance: Understanding the Basics. Insurance Journal. https://www.insurancejournal.com/magazines/mag-features/2020/03/02/559968.htm
Johnson, M. (2021). Professional Liability Insurance: A Necessity for Protecting Your Business. Forbes. https://www.forbes.com/sites/forbesfinancecouncil/2021/04/01/professional-liability-insurance-a-necessity-for-protecting-your-business/
Jones, P. (2019). General Liability vs. Professional Liability Insurance: What’s the Difference? Risk Management Magazine. https://www.rmmagazine.com/2019/09/04/general-liability-vs-professional-liability-insurance-whats-the-difference/
Manning, K. (2017). General Liability Insurance: What It Covers and How It Works. The Balance Small Business. https://www.thebalancesmb.com/what-is-general-liability-insurance-462395
Smith, J. (2018). The Basics of General Liability Insurance. Investopedia. https://www.investopedia.com/terms/g/general-liability-insurance.asp
Smith, J. (2019). The Importance of Professional Liability Insurance. Investopedia. https://www.investopedia.com/articles/personal-finance/061715/importance-professional-liability-insurance.asp
Difference Between Coverage Conditions and Supplementary Payments
Insurance policies are often packed with terminology that can be challenging to decipher for the average policyholder. Two terms that frequently cause confusion are “coverage conditions” and “supplementary payments.” In this article, we will delve into the distinctions between these concepts, shedding light on their respective roles within insurance contracts.
Coverage conditions are the specific requirements and obligations outlined in an insurance policy that the policyholder must adhere to for the coverage to be valid. These conditions typically specify the circumstances under which the insurance company will provide coverage. Examples of coverage conditions include timely premium payments, prompt reporting of claims, and compliance with safety regulations.
For instance, in a homeowners insurance policy, there might be a coverage condition stating that the policyholder must install smoke detectors in the house. Failure to meet these conditions might jeopardize the policyholder’s ability to make a successful claim.
On the other hand, supplementary payments refer to additional financial assistance provided by the insurance company, beyond the basic coverage limits, to the insured party. These payments are designed to cover expenses that may arise in connection with a covered loss. Supplementary payments often include legal fees, medical expenses, or other costs incurred by the policyholder during the claims process.
Consider an auto insurance policy that includes supplementary payments for legal defense costs. If the insured is involved in a car accident and faces a lawsuit, the insurance company may contribute to covering the legal expenses associated with defending the insured in court.
- Coverage Conditions: Focus on outlining the terms and obligations necessary for the policy to remain in force.
- Supplementary Payments: Serve to provide additional financial support beyond the basic coverage limits.
- Coverage Conditions: Are prerequisites that, when met, ensure the policy remains valid.
- Supplementary Payments: Are financial aids extended by the insurer to assist the policyholder in specific situations.
- Coverage Conditions: Premium payment, timely reporting of incidents, compliance with safety measures.
- Supplementary Payments: Legal defense costs, medical expenses, additional living expenses.
Understanding the nuances of coverage conditions and supplementary payments is crucial for policyholders navigating the complex landscape of insurance policies. While coverage conditions define the rules and requirements for maintaining coverage, supplementary payments offer a financial safety net beyond the basic policy limits. By comprehending these distinctions, policyholders can make more informed decisions and better leverage the benefits provided by their insurance policies.