Evidence That Nurses Need to Participate in Diagnosis: Lessons From Malpractice Claims.

MedStar author(s):
Citation: Journal of patient safety. 17(8):e959-e963, 2021 12 01.PMID: 32217927Department: Assistant Vice President | MedStar Institute for Quality and SafetyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Clinical Competence | *Insurance Claim Review | *Malpractice | *Nursing Diagnosis | Clinical Competence | Humans | Logistic Models | Retrospective Studies | United StatesYear: 2021Local holdings: Available online through MWHC library: March 2005 - presentISSN:
  • 1549-8417
Name of journal: Journal of patient safetyAbstract: CONCLUSIONS: Nurses are held legally accountable for their role in diagnosis. Raising system-wide awareness of the critical role and responsibility of nurses in the diagnostic process and enhancing nurses' knowledge and skill to fulfill those responsibilities are essential to improving diagnosis. Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved.METHODS: We conducted a review of the Controlled Risk Insurance Company Strategies' repository of malpractice claims, which contain approximately 30% of United States claims. We analyzed the malpractice claims related to diagnosis (n = 139) and physiologic monitoring (n = 647) naming nurses as the primary responsible party from 2007 to 2016. We used logistic regression to determine the association of contributing factors to likelihood of death, indemnity, and expenses incurred.OBJECTIVES: There is a pressing need for nurses to contribute as equals to the diagnostic process. The purpose of this article is twofold: (a) to describe the contributing factors in diagnosis-related and failure-to-monitor malpractice claims in which nurses are named the primary responsible party and (b) to describe actions healthcare leaders can take to enhance the role of nurses in diagnosis.RESULTS: Diagnosis-related cases listing communication among providers as a contributing factor were associated with a significantly higher likelihood of death (odds ratio [OR] = 3.01, 95% confidence interval [CI] = 1.50-6.03). Physiologic monitoring cases listing communication among providers as a contributing factor were associated with significantly higher likelihood of death (OR = 2.21, 95% CI = 1.49-3.27), higher indemnity incurred (U.S. All authors: Cahill M, Gleason KT, Goeschel C, Graber M, Greenberg P, Harkless G, Jones R, Rhodes COriginally published: Journal of patient safety. 17(8):e959-e963, 2021 12 01.Journal of patient safety. 17(8):e959-e963, 2021 Dec 01.Fiscal year: FY2022Fiscal year of original publication: FY2022Digital Object Identifier: Date added to catalog: 2020-07-09
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 32217927 Available 32217927

Available online through MWHC library: March 2005 - present

CONCLUSIONS: Nurses are held legally accountable for their role in diagnosis. Raising system-wide awareness of the critical role and responsibility of nurses in the diagnostic process and enhancing nurses' knowledge and skill to fulfill those responsibilities are essential to improving diagnosis. Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved.

METHODS: We conducted a review of the Controlled Risk Insurance Company Strategies' repository of malpractice claims, which contain approximately 30% of United States claims. We analyzed the malpractice claims related to diagnosis (n = 139) and physiologic monitoring (n = 647) naming nurses as the primary responsible party from 2007 to 2016. We used logistic regression to determine the association of contributing factors to likelihood of death, indemnity, and expenses incurred.

OBJECTIVES: There is a pressing need for nurses to contribute as equals to the diagnostic process. The purpose of this article is twofold: (a) to describe the contributing factors in diagnosis-related and failure-to-monitor malpractice claims in which nurses are named the primary responsible party and (b) to describe actions healthcare leaders can take to enhance the role of nurses in diagnosis.

RESULTS: Diagnosis-related cases listing communication among providers as a contributing factor were associated with a significantly higher likelihood of death (odds ratio [OR] = 3.01, 95% confidence interval [CI] = 1.50-6.03). Physiologic monitoring cases listing communication among providers as a contributing factor were associated with significantly higher likelihood of death (OR = 2.21, 95% CI = 1.49-3.27), higher indemnity incurred (U.S. 6,781, 95% CI = 8,058- 75,505), and higher expenses incurred (U.S. 0,575, 95% CI = 685- 7,465).

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