Nurses play a critical role in providing quality healthcare, but they also face potential liability risks that can lead to malpractice lawsuits. Understanding the most common reasons nurses get sued can help identify areas to target for improving patient safety and reducing liability exposure.
Medication Errors
Medication errors are one of the leading reasons nurses get named in malpractice lawsuits. According to claims data, medication errors account for around one quarter of all nursing malpractice claims. Some examples of medication errors that often lead to lawsuits include:
- Administering the wrong medication
- Administering the wrong dose of medication
- Failing to properly monitor patients after medication administration
- Incorrect medication documentation
- Failing to spot potential adverse drug interactions
Medication administration is a key nursing duty. Even small mistakes can cause patient harm and prompt legal action. Strategies to reduce medication error risks include double checks before administering, careful documentation, medication barcode scanning, pharmacist review of high-risk medications, and adequate nurse staffing levels.
Failure to Monitor Patients Properly
Along with medication errors, failure to properly monitor patients ranks highly among reasons for nursing malpractice claims. Nurses are expected to regularly assess vitals, monitor equipment, and watch for changes in patient status. Failure to recognize and act upon clinical deteriorations in patients can lead to poor outcomes.
Some common nursing monitoring lapses that provoke lawsuits include:
- Failure to monitor patient vital signs
- Failure to track intake and output
- Failure to review test results
- Failure to monitor patient post-operative status
- Failure to assess health history for risk factors
- Failure to document assessments properly
Diligent monitoring and timely intervention when issues arise are essential for patient well-being. Nursing vigilance is key for reducing risks. Adequate nurse-patient ratios can also help ensure proper monitoring occurs.
Communication Breakdowns
Communication problems represent another prevalent area where nursing negligence can occur. Poor communication leads to critical information getting missed, which can compromise patient safety. Some examples of communication lapses include:
- Failing to clearly convey physician orders
- Failing to report abnormal patient symptoms
- Incomplete or inaccurate shift change handoffs
- Lack of communication with other care providers
- Failure to educate patients properly on medications
Strategies to improve communication include thorough shift reports, read-back of verbal orders, team huddles, and protocols for critical test result reporting. Health information technology like electronic health records can also help enhance communication when used effectively.
Documentation Errors
Proper nursing documentation provides an essential record of patient status assessments, care administration, and communication. Incomplete or inaccurate documentation can impede care coordination and make it appear as if appropriate standards were not followed.
Documentation problems that commonly lead to liability claims include:
- Late or missing entries
- Copy and paste documentation
- Failure to record medications or treatments
- Inaccurate vascular sign documentation
- Lack of consent form documentation
Thorough documentation is key for demonstrating diligent care delivery. Strategies like contemporaneous charting, narrative charting, and periodic audits help enhance documentation quality.
Improper Use of Restraints
The use of physical and chemical restraints can be necessary at times for patient safety, but improper use can lead to harm. Lawsuits may occur if policies on restraints are not followed properly. Some common issues include:
- Using restraints without a physician order
- Failure to document restraint use
- Failure to appropriately monitor restrained patients
- Use of excessive restraint force
- Failure to attempt alternatives before restraint use
Follow protocols for restraint orders, monitoring, and graduated use. Also utilize risk assessment tools and look for less restrictive strategies when possible.
Failure to Assess and Intervene with Fall Risks
Patient falls are a major nursing quality issue. If nurses fail to assess fall risks and implement interventions, injuries from falls can prompt lawsuits. Areas where nursing negligence may occur include:
- Inadequate fall risk assessment
- Failure to engage fall precautions like bed alarms, supervision, and assistance
- Failure to identify environmental fall hazards
- Letting patients get up unattended when deemed high fall risk
Conduct rigorous fall risk screening. Follow protocols on fall prevention including things like frequent rounds, low beds, clutter-free rooms, and post-fall huddles to identify causes.
Failure to Identify and Treat Bedsores
Bedsores or pressure ulcers are a common complication in immobile patients. Nursing negligence in preventing and treating bedsores can lead to lawsuits if the sores worsen or become infected. Common nursing lapses include:
- Failure to assess skin condition regularly
- Failure to identify bedsore risks
- Failure to reposition immobilized patients regularly
- Failure to utilize pressure relief surfaces
- Failure to maintain skin hygiene
Conduct risk assessment to identify vulnerable patients. Follow protocols on frequent repositioning, pressure relief products, skin assessment and hygiene. Involve wound care specialists promptly if sores develop.
Failure to Recognize Sepsis Risk
Sepsis is a dangerous condition that can lead to organ damage and death if not treated promptly. Nursing negligence in identifying sepsis symptoms and quickly reporting concerns can delay life-saving treatment. Reasons for lawsuits may include:
- Failure to monitor patients for sepsis red flags
- Failure to notify physicians about signs of sepsis
- Failure to document sepsis assessments and concerns
Utilize tools like screening checklists and early warning systems to identify potential sepsis cases. Follow protocols to rapidly report concerns and expedite treatment.
Birth and Labor Related Errors
Childbirth involves major risks requiring diligent nursing care. Mistakes during the labor or delivery process can lead to poor maternal and infant outcomes. Examples include:
- Failure to monitor fetal heart rate
- Failure to recognize signs of fetal distress
- Failure to monitor mother’s vitals and blood loss
- Improper use of vacuum or forceps
- Delayed emergency cesarean response
Closely follow standards on high-risk deliveries. Utilize techniques like simulation drills to hone responses to obstetric emergencies.
Failure to Identify Abuse or Neglect
Nurses have a duty to watch for and report any signs of abuse or neglect. Lawsuits can occur if warning signs are missed. This may involve cases like:
- Failure to report suspected elder abuse
- Failure to identify signs of child abuse
- Failure to report dangerous conditions in neglect cases
- Failure to note injuries suggesting abuse
Be vigilant for potential signs of maltreatment and danger. Follow reporting mandates and protocols if abuse or neglect is suspected.
Privacy and Confidentiality Breaches
Nurses must safeguard patient privacy and medical data confidentiality. Lawsuits may arise if policies on protected health information are violated. Examples include:
- Sharing private patient information improperly
- Snooping in confidential patient records
- Posting information on social media
- Leaving medical records unsecured
Get clear consent before sharing information. Follow protocols on securing records and devices. Only access confidential data when required for the care situation.
Negligent Discharge Planning
Planning for safe discharges is a key nursing role. Liability may occur if discharge instructions or planning are inadequate. Reasons include:
- Failure to educate patients properly on self-care
- Sending patients home before sufficiently medically stable
- Failure to coordinate adequate home services
- Failure to confirm patient comprehension of instructions
Utilize tools like teach-back and printed materials to educate on self-care and medications. Ensure medical stability and proper follow-up before discharge. Coordinate home services based on assessed needs.
Failure to Intervene with Unsafe Practice
Nurses have an ethical duty to speak up about unsafe practices by other providers that can jeopardize patients. Lawsuits can occur if nurses fail to intervene with issues like:
- Providers performing procedures without proper competence
- Impaired providers attempting to do patient care
- Verbal or medical orders that seem unsafe or inappropriate
- Observed medication diversion
Empower nurses to report unsafe conditions without fear of reprisal. Develop clear protocols for intervening with potentially unsafe situations in a constructive manner.
Conclusion
Understanding why nurses get sued helps identify vulnerable areas to target for improvement. While not every claim naming a nurse for negligence results in liability, lawsuits take an emotional toll and affect professional reputation regardless of outcome. Strategies like honing critical thinking skills, improving nurse-patient communication, using checklists and protocols, and fostering teamwork and speaking up when concerned can help reduce liability risks. Balancing diligent patient care with self-care is also important for managing nursing practice demands and stress.