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Your facility receives a letter from a personal injury attorney who alleges that you, personally, along with your facility were negligent in the care, more specifically, wound care, of a former patient. You are petrified!
Being forewarned with some helpful tips can prevent the likelihood of such an occurrence.
We as nurses are not familiar with the legal system. We have nothing to do with it, if it’s a good day! We go to work with the intention of providing the best care to our patients and don’t often think of being involved in any litigation.
There are several mistaken beliefs that favor the plaintiff in pressure ulcer litigation cases:
The staging system itself: the most powerful weapon in the arsenal of the plaintiff’s attorney is the current pressure ulcer staging system. The numeric nature of the staging system implies progression through the stages, even though the website of the National Pressure Injury Advisory Panel (NPIAP, formerly the NPUAP) states differently. However, the NPIAP website defines the mechanism of pressure injury as “localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device.” This definition implies an “outside to inside” progression. When juries are told that a wound “progressed,” this implies that if the clinician had done the right thing, the wound would not have “progressed.” The attorney likes to show that a stage II wound progressed to a stage IV.
How to reduce your risk of litigation:
While the focus of this piece is to reduce your risk of litigation, it is also to reduce the risk of pressure ulcers in your patients. All wounds are a symptom of disease and pressure injuries are symptomatic of many diseases (e.g. poor nutrition, poor hydration, fragile skin, immobility, muscle weakness, etc.).
Here are some ways that clinicians can reduce the risk of litigation around pressure ulcers:
Document patient and family education around pressure injury prevention (e.g., the importance of nutrition, hydration, skin care, etc.).
A recurring theme among family members who file malpractice suits is that they, “simply could not get their questions answered.” A family conference takes much less of the clinician’s time than dealing with a malpractice suit.
Patients may also believe they are owed a monetary settlement for their suffering and that since it will be paid by an insurance company, filing a lawsuit is simply the means to receiving an insurance payment. They may be unaware that clinicians will be formally accused of either negligence or malpractice and even if the case is dismissed, the mere fact the suit was filed will follow a practitioner for the rest of their lives when they obtain or renew hospital privileges or when they join care organizations.
So, avert such a letter coming to your facility and yourself!
Nancy Morgan RN, BSN, MBA, WOCN is an experienced clinician, successful business leader, and accomplished nurse educator in the field of wound management. She is the co-founder of the Wound Care Education Institute, (WCEI®), Wild on Wounds Productions; and, most recently established Nancy Morgan Wound Care offering innovative, educational resources including seminars, webinars, social media and wound care marketing tools to assist and support wound care clinicians at the bedside. Nancy is one of the most distinguished wound care educators, delivering nearly 1200 lectures, conference keynote addresses, seminars, webinars, and bedside consultations during her career.
Information is courtesy of Nancy Morgan Wound Care, copyright 2022.