Legal Issues in the Health Care System

Our current health care system is in a fluid state. Change is constant. As health care providers, we strive to deliver optimal, safe care. Ongoing health care research, evidenced-based care, and effective guidelines for practice offer a stabilising force. Our duty, as health care providers, is to “do no harm.”

As providers, Nurse Practitioners (NP) provide preventive, acute, and chronic care, which entails complex management. Understanding legal terminology is essential to the role. Terms such as standard of care, malpractice, and negligence are inevitable and essential components for understanding the legal challenges advanced practice nurses will experience during their careers.

Only 1% of patients actually sue for malpractice in the U.S. and NPs are the least likely to be sued of all providers (Buppert, 2018). Just because an NP is sued does not mean the provider will be reported to the State Board of Nursing. Remember, the State Board of Nursing’s focus is not to protect the NP; their role is to protect the public. In many instances, the NP will be named in a Malpractice Lawsuit and later removed.

Unfortunately, their name will be forever in the National Practitioner Data Bank, which we will discuss in further detail during this week’s Discussion.

This week, as you examine legal issues related to Nurse Practitioner Practice, focus on the implications of the legal terms you will be introduced to and how they will impact your day-to-day decisions in regard to patient care and safety.

Consider strategies to improve your clinical practice skills and maintain current with legislative issues in your state.

Buppert, C. (2015). Nurse Practitioner’s Business Practice and Legal Guide (5th ed..). Burlington, MA: Jones & Bartlett. Chapter 7, (pp. 271-284).

Learning Objectives

By the end of this week, students will:

Analyse key components of malpractice policies

Analyse legal implications that exist for failure to adhere to a standard of care

Compare differences in malpractice policy options

Evaluate professional strengths and weaknesses

Evaluate mastery of NP clinical skills

Learning Resources

Required Readings

Agency for Healthcare Research and Quality (2016). National Guideline Clearinghouse. Retrieved from http://www.guidelines.gov

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

Chapter 8, “Risk Management”

This chapter reviews lawsuits, malpractice, the importance of working within practice guidelines, and explains the purpose of the National Practitioner Data Bank.

Jordan, L. M., Quraishi, J. A., & Liao, J. (2013). The national practitioner data bank and CRNA anaesthesia-related malpractice payments. American Association of Nurse Anaesthetists Journal, 81(3), 178-182.

Miller, K. P. (2013). The national practitioner data bank: An annual update. The Journal for Nurse Practitioners, 9(9), 576-580. doi: 10.1016/j.nurpra.2013.06.013

Stelmach, E. I. (2015). Dismissal of the non-compliant patient: Is this what we have come to? The Journal for Nurse Practitioners, 11(7), 723-725.

Watson, E. (2014). Nursing malpractice: Costs, trends and issues. Journal of Legal Nurse Consulting, 25(1), 26-31.

Westrick, S. J., & Jacob, N. (2016). Disclosure of errors and apology: Law and ethics. The Journal for Nurse Practitioners, 12(2), 120-126. 120–126. doi: doi: 10.1016/j.nurpra.2015.10.007

Required Media

Institute of Medicine. (2015, December 7). Assessing Progress on the Implementation of the Recommendations of The Future of Nursing [Video file]. Retrieved from https://www.youtube.com/watch?v=sMOjACA2ats

Note: The approximate length of this media piece is 1 hour.

Optional Resources

Buppert, C. (2016). Carolyn Buppert-Specialist in Legal and Reimbursement Issues for Nurse Practitioners and Physicians.

Goodwin, B. (2016). You’ve been sued for malpractice: What happens next? Urology Times. Retrieved from https://www.urologytimes.com/modern-medicine-feature-articles/youve-been-sued-malpractice-what-happens-next

Kreimer, S. (2015). Avoiding an EHR-related malpractice suit. Medical Economics. Retrieved from http://www.medicaleconomics.com/health-law-policy/avoiding-ehr-related-malpractice-suit

Assignment 1: Recognizing the Role of Adhering to the Standard of Care

When providing health care, there are standards of care which a reasonably prudent provider should follow. Providers at all levels are held to these standards of care. Failure to provide competent care to your patients will put you at risk for malpractice. Remaining current with the evidenced-based guidelines and providing optimal care will minimize the risk of liability.

For this Assignment, you will create a PowerPoint presentation that explains any legal implications that exist for failure to adhere to a standard of care, the key elements of malpractice, and compare the differences in malpractice policy options.

To prepare:

Consider the importance of using professional resources such as the National Guideline Clearinghouse to guide care delivered

Create a PowerPoint presentation no more than 15 slides in length that addresses the following:

Explain, in your own words, what regulatory and coding compliance for APRNs means to your practice

Compare coding compliance issues within the state you intend to practice and federal regulations

Identify and explain any legal implications that exist for failure to adhere to a standard of care

Identify and explain the key elements of malpractice

Compare the differences in malpractice policy options

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