Legal Malpractice Case : Yolanda Pinnelas

From early on, nurses learn to use their better judgment when providing care. Thinking critically can aid nurses greatly. Considering this, standard precautions are viewed as a systematic approach at preserving the well being of themselves and others. But if all of this is true, then what prevents nurses from implementing standards of precautions in their daily practice with each patient they care for? The purpose of this paper is to explore what factors may influence nurses to become noncompliant. For varying reasons, data shows that nurses have the lowest reports of compliance. Therefore, it is especially necessary to analyze these factors and educate nurses on the importance of adherence. Factors such as lack of knowledge, time pressure, and poor practice and/or qualifications contribute greatly to nurses not adhering to their standards of precautions when proving patient

healthcare organization accrediting bodies, and to maintain credibility with patients and peers alike, must adhere to the National Patient Safety Goals. As stated by Ulrich and Kear (2014), "Not only are nurses responsible for providing safe patient care, we are also responsible for creating an environment in which others can provide safe patient care, and for being the last line of defense when needed between the patient and potential harm. Having a deep understanding of patient safety and patient safety culture allows nurses to be the leaders we need to be in ensuring that our patients are always

The purpose of this paper is to discuss how safety in the nursing profession affects the nursing education, nursing practice, and nursing research. Safety in the nursing profession means to minimize the risk of harm to patients and providers through both system effectiveness and individual performances (QSEN, 2014). Patient safety is a very important aspect in the profession of nursing. It is the nurse’s job to keep up to date with their patients and to make sure that protocol is being followed at all times. To maintain this strategy, the nurse must show proper knowledge of a nurse, skills of a nurse, and also a professional attitude.

When nurses are held to a professional standard, staffing becomes safer and more efficient. The professional standard created by the American Nurses Association Code of Ethics (ANACEN) for Nurses is commonly used. The standard is made up of nine points that ensure patients will receive the highest quality of care. The purpose of the standard is to determine whether nurses have the assets, abilities, responsibility, and expertise to make judgments concerning professional practice and optimum care for patients and families (Clevenger, et al. 2005). The goal of safe staffing is to provide optimal care for patients and the patients’ families, so facilities should invest in nurses with a high degree of professionalism who can

Nurses are undoubtedly one of the most trusted professionals worldwide. Patients, family members, and doctors entrust nurses to provide the utmost quality care to sick individuals. Top priorities of all nurses are advocacy for their patients: including advocating for their physical health, holistic welfare, and utmost importantly, their safety. Patient safety will always be the top priority when providing patient care. The nurse’s responsibility during every patient encounter is to ensure that each patient under her care, receives no harm. As a direct result of the previous statement, it is crucial that every nurse knows their rights to refuse unsafe patient assignments, the process to refuse unsafe patient assignments, and the legal or ethical ramifications that could present themselves if proper judgement is not used. By understanding these rules, nurses not only achieve the responsibility of advocating for patient safety but also safeguard their careers and license.

Nurses’ are to ensure patient safety in all aspects of care provided. Sometimes, this is found outside of what is considered “actual” care, such as a physical assessments and administration of medications. Every day nurses’ are given assignments to follow, which includes which patients to take care of. What happens when this assignment is unsafe for all involved? Administrative Codes have been established by each state Board of Nursing to guide nurses’ in different situations. Safe Harbor Peer Review assists nurses to know how to handle an unsafe assignment.

With all of these regulations and standards in place, one would think that all nurses work at the same standard that has been outlined and therefore safety is of no concern. Yet, a peer review conducted a study on the safety of student and graduate nurses. They concluded that unprofessional image consisted of repetitive errors, disrespect, anger, defensiveness, overconfidence, low confidence, and apathy.

The American Nurses Association (ANA) “Code of Ethics for Nurses” (ANA, 2001) states: “The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient”. This reflects that advocating for the patient directly correlates with the safety and well-being of the patient. The key part to patient advocacy is effective communication. In recent times, there has been a focus on the connection of effective communication between healthcare workers and patient safety. A number of Institute of Medicine reports has brought focus to the severe matter. The reports have emphasized the concern of the lack of communication in the healthcare setting and the resulting negative patient outcomes. (Hanks, 2012a). This goes back to the notion that while many healthcare professionals consider themselves as a working member of a team, we have the natural tendency to work autonomously. Therefore, it is the nurse’s duty to collaborate patient centered care by practicing good communication skills with the entire healthcare team, the patient, and the patient’s family if consent is given to assure patient safety.

The first case scenario presented in this project reflect the significance of gaps between nursing programs and textbooks, organizations’ policies and procedures, published literature, and the actual practice. Some of the gaps refer to nursing programs and textbooks based on an ideal nursing profession, the autonomy of healthcare organizations to establish their specific policies and procedures, traditional policies and procedures unsupported by evidence-based practice (EBP), and the individual and organizational barriers that influence the breach between the published literature and the real-world. Literature review was used to demonstrate the negative personal and professional consequences triggered from these gaps when the nurse is employed in the healthcare system. In addition, the paper suggests how improving a “Culture of Safety”, preventing an unsafe environment, and promoting Continuous Quality Improvement activities enhance the overall health care quality and safety. The second case scenario provides guidelines to the ethical dilemma of the impaired nurse, signs and symptoms of impairment, ethical and legal obligations, common reasons for not reporting, and failing to report consequences.

Today’s healthcare environment is evolving and changing rapidly and it is imperative for nurses and other healthcare providers to be aware of the most recent changes and mandates in healthcare delivery practices. The origins of the reform date back to late 1990s and early 2000s, when the Institute of Medicine (IOM) released its original report To Err is Human: Building a Safer Health System, on the prevalence of medical errors, and directed the nation’s attention to the need for modification of medical practices (Kronick et al., 2016). The IOM’s report stressed the importance of providing a safe healthcare environment, where patients receive quality patient-centered care and nurses are equipped with sufficient knowledge

Standards of care can be seen as the level of competence expected from a “reasonably prudent nurse” when carrying out duties with the expectation of yielding positive outcomes (Westrick, 2014). Westrick also explains that nurses can face legal charges when there are breaches in the expected standards of care. Nursing malpractice occurs when the actions or inactions of a nurse—breaches in the expected standards of care—results in harm to the patient.

As a nurse, an individual’s safety is top of the list (Lewis et al., 2014). Make sure that any type of sharp objects or items that may injure an individual is out of reach (Lewis et al., 2014). Make sure that the rails are padded and that suction supplies are at the bedside in case they are needed (Lewis et al., 2014). Monitor the individual to make sure they are compliant with medication therapy (Lewis et al.,

According to Westrick, 2014, the plaintiff’s claim may be proven based on four elements: (1) the defendant has a duty to the plaintiff, (2) the defendant failed to perform her duty or failed to act reasonably, (3) the breach of duty caused damages or injury to the plaintiff, and (4) the presence of proximate causation between the breach of duty and the resultant injury. Failure to prove any of the four elements will cause the failure of the plaintiff’s claim and a valid defense for the defendant. In Case Study I: Malpractice Action Brought by Yolanda Pinnelas, Ms. Pinnelas is the patient and the plaintiff. Her claim based on the four elements will come out as: (1) Ms. Pinnelas was admitted in the hospital. The Caring Hospital and its staff has the duty to safely provide care to her. The Caring Hospital has the corporate liability for her care. (2) Breach of duty that may have caused her injury were identified. The chemotherapy medication was delivered late. The response time for staff to answer the bells and alarms were long. Risk Management, Equipment safety procedures. No report about the malfunctioning of the pump was documented nor was it separated and labeled as malfunctioning equipment. Gaps in nursing documentation of nursing assessment, interventions and re-evaluation of the patient after the IV chemotherapy was discontinued. Ms. Pinnelas had also undergone surgical procedures after the hand was found necrotic, the surgical procedures caused scarring to the tissues

     There are two specific cases that show how the standard of care is used in the determination of cases in certain situations. They both take place in Canada, and they both pertain to nurses that had left their posts to go on there coffee breaks. One of these cases was proved to be negligent, while the other was proven not to be a case of negligence. These are both taken from the publication Nursing and the Law:

There are many different variations of healthcare professionals that assist people in regaining and maintaining a healthy lifestyle. The career field of licensed nursing is often considered to be one of the most vital professions within the medical community. Registered nurses work to prevent and heal various different types of injuries, diseases, and illnesses. They are also responsible for administering a variety of patient services, consisting of individual patient care, analyzing and monitoring patient medical reports, and also possessing the ability to operate technical medical equipment. As well as, be able provide comfort and emotional support for both physically, and mentally ill patients. All Registered Nurses are responsible for providing patients with quality health care, in compliance with professional standards set forth by the American Nurses Association. As the field continues to rapidly evolve, an increase in responsibility is placed upon registered nurses to maintain a professional standard of care. With the increase in responsibility, the role of registered nurses consistently changes to accommodate individual patient needs. As a result, the rise in responsibility placed on registered nurses correlates to a higher probability of malpractice and negligence occurring within the community. The consequences of malpractice and negligence can