Three Risks that Increase the Liability of Nurses

Risks are rising in the complex practice of nursing and health care, any of which could potentially lead to a liability or malpractice claim.

As a nurse, you show up each day to give your very best to each person you care for. At times you may also stay awake at night wondering if you completed all of the appropriate care, tasks, communication, and other professional accountabilities for each of your patients. If so, you are not unlike many other health care providers. 

Risks are rising in the complex practice of nursing and health care, any of which could potentially lead to a liability or malpractice claim. First, medication-related claims are common. As bedside nurses manage increasing numbers of medications in nearly all settings of practice, technology including bar-coded medication administration (BCMA), advanced clinical IT systems with alerts and smart infusion devices add to the safety of medication delivery. Adhering to the basic principles, including verification of the “5 Rights” prior to administering medications also adds safety to the process and prevents errors. Minimizing distractions during all phases of medication preparation and administration also reduces errors. Monitoring and assessing patients prudently, and acting quickly when medication management issues such as infiltrations and side effect arise can reduce harm to patients and reduce nurse liability.

Second, managing the changing condition of a patient is an area of risk for the nurse. Timely assessment and monitoring, as well as prompt escalation of condition change, is expected. Clear communication using evidence-based methods such as SBAR (situation-background-assessment-recommendation) convey the level of concern of the nurse to the provider. A medical emergency response team should be called (if available) to promptly manage a significant change in condition. All assessments and communication should be documented, and new care orders should be implemented immediately. 

Third, liability risk for nurses continues related to general safety. Harm associated with falls, wound management, behavioral health, and placement and use of tubes and lines creates potential liability. Inconsistent use of evidence-based safety procedures such as Universal Protocol prior to procedures and surgical fire prevention measures are also commonly seen in malpractice claims. Providing care according to policies and procedures is essential. Thorough and accurate assessment with timely documentation in the medical record is best, and must accurately reflect all aspects of care to “tell the patient story” and demonstrate critical thinking by the nurse.

Employing strategies to reduce your professional liability can facilitate safe care and positive patient outcomes. General risk mitigation strategies such as practicing within the scope of the RN license, fostering positive relationships with patients and families, following accepted standards and procedures, complete and timely documentation, and ongoing training reduce nurse liability risk. 

Despite the true privilege of practicing as a nurse, the responsibility is immense. You must ensure the delivery of care as planned to achieve patient safety and intended outcomes. You are human, and humans can make mistakes. It’s important to promote a culture of safety, transparency, and accountability. All healthcare professionals are encouraged to report errors and near misses and learn from mistakes in order to improve patient safety and avoid lawsuits. 

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