Recently I had an opportunity to review the Nursing Service Organization (NSO) Nurse Professional Liability Exposure 2015 Claim Report Update, which looked at claims regarding assessment and monitoring, treatment and care, chain-of-command and scope of practice. I always find these types of reviews to be so interesting.
Several surprising things I noticed in this report included 23.9% of the claims involved agency nurses with the majority being from home care agencies. Another surprise was director of nursing claims of which the majority came from gerontology and aging services facilities. This is not surprising although when I was doing medical malpractice defense, I don’t believe I ever represented a Director of Nursing.
Almost 70% of the director of nursing claims were related to deaths of patients. It also is no surprise that the 3 most common causes of death were 1) cardiopulmonary arrest, 2) pressure ulcers and 3) bleeding flesh hemorrhage.
The NSO survey also reviewed that med surg nurses had, at almost 18%, the most number of claims. Long-term care counted for 17% whereas the emergency room counted for only 11%.
Also in the report was mentioned that many of the medication errors resulted in workarounds or nurses taking shortcuts in violation of facility policies and procedures.
License defense paid claims are highlighted in one part of the survey. NSO does provide a disciplinary defense reimbursement benefit should you need to hire an attorney to represent you for any claim against your license.
From 2010 to 2014, NSO paid benefits for 1,301 R.N.’s, L.P.N.’s/L.B.N.’s. Of that number, 60% of R.N.’s was located in the hospital where the number one claim was for professional conduct. For the L.P.N.’s, 57.5% were located in long term care facilities and the number one claim for that group was a tie of improper treatment/care with medication administration.
While substance abuse and diversion had the highest percentage, it was only a portion of the total claims for professional conduct where 60% were claimed against R.N.’s and 66% against L.P.N.’s. It is also worthy to note that approximately 50% of the claims were closed with no action.
It was noted that license defense claims increased 15.4% since the 2011 claim report which means that claims against nurses’ licenses are on the rise. It was noted that the number of claims against men was roughly the same as against women but this is tempered by the fact that women constitute a much larger portion of the program.
The highest paid claims were in the areas of occupational health, neurology and obstetrics. The number involving occupational health surprised me but that could be a big area for failure to diagnose.
Also reviewed in the study was technology and whether such impacted claims. Having regular staff development opportunities appeared to have a positive effect on liability claims and payments.
Most of the nurses noted in the study believe that streamlining their practices with technology will enhance patient safety and, at the same time, nurses not having a rapid response team are more likely to risk a claim.
The NSO report also included a qualitative nurse work profile survey wherein one interesting statistic was that the majority of nurses (85%) who experienced a claim had been in practice for at least 16 years. So, it is not only new nurses being discipline but it may be because the more senior nurses become complacent and comply with unit norms that may not be within the policies and procedures or our Nurse Practice Act.
This report is very comprehensive and I strongly encourage you to look at it.
In the report is a risk assessment so you can see for yourself where you may be risking a medical malpractice claim.
I would encourage you to review the NSO report at these links:
http://www.nso.com/Documents/pdfs/CNA NURSE CLAIM REPORT 101615.pdf
After you have had a chance to look at the report, I would love to hear what you think. Please leave your comments below.