advance, Leadership and education teaching (Due 24 hours)

NAPNAP POSITION STATEMENT

Position Statement on Malpractice Insurance for Nurse Practitioners

The National Association of Pediatric Nurse Practi- tioners (NAPNAP) recognizes that nurse practitioners (NPs) need access to affordable and adequate malprac- tice insurance, also called medical professional liability insurance, to protect themselves and their patients.

Advanced practice registered nurses (APRNs) are gaining practice autonomy and responsibility in an in- creasingly complex health care delivery system. NPs have a responsibility to protect the individuals they care for and themselves by practicing within the scope of practice as mandated by state statute, rules, and reg- ulations (Balestra, 2012; National Council of State Boards of Nursing, 2014). It is recognized that as the workforce has grown, the number of malpractice claims involving nurse practitioners has increased; however, the percentage of claims has remained stable and is the lowest among health care professionals (LeBuhn & Swankin, 2010; Miller, 2011).

Malpractice insurance protects health care providers and the individuals for whom they provide care. The in- clusion of license protection defense is another impor- tant component of malpractice insurance that is designed to protect NPs in the event of regulatory or dis- ciplinary action (Balestra, 2012). Although an employer may provide malpractice insurance coverage, it may not fully protect individual NPs or their APRN license.

Adopted by the National Association of Pediatric Nurse

Practitioners’ Executive Board on February 17, 2015. This

document replaces the 2009 NAPNAP Position Statement on

Malpractice Insurance for Nurse Practitioners.

All regular position statements from the National Association of

Pediatric Nurse Practitioners automatically expire 5 years after

publication unless reaffirmed, revised, or retired at or before that time.

Correspondence: NAPNAP National Office, 5 Hanover Square,

Suite 1401, New York, NY 10004.

J Pediatr Health Care. (2015) 29, A11-A12.

0891-5245/$36.00

http://dx.doi.org/10.1016/j.pedhc.2015.04.015

www.jpedhc.org

Therefore, NPs are encouraged to analyze employer- provided coverage to determine whether carrying indi- vidual malpractice insurance is warranted (Barry, 2006; Buppert, 2007; Liguori & Jones, 2006). NPs have a responsibility to understand the malpractice risks in their own work setting and to be aware of the type of coverage afforded by their employer-provided and/or individual malpractice policies. NPs provide a range ofservicesand activities that have

the potential to affect their patients, positively or ad- versely. Patients have legal rights to receive adequate and appropriate diagnosis and treatment or referral to a specialist that is consistent with the expected stan- dard of care (National Association of Insurance Commissioners, 2014). If they believe they have not re- ceived such care from the NP, they can file a legal claim against him/her. Complaints may also be registered at state Boards of Nursing (Balestra, 2012). Some of these claims may be warranted, and if the claim is so judged, malpractice insurance can pay for the NP’s legal fees and pay the patient damages awarded and legal fees that are assessed by the defense and prosecution, subject to the limits of the policy or policies. Any claims resulting in a monetary settlement or judgment are also subject to reportingintheNationalPractitioner Data Bank(NPDB). The NPDB is subject to review with licensure, hiring, or certification to participate in government programs such as Medicaid. Provider identification within the NPDB is viewed as reflective of negative past performance and has implications foranNP’sfuture practice opportunities (Jordan, Quraishi, & Liao, 2013). Therefore, it is impor- tant for protection of both the NP and the public that NPs understand the implications of both malpractice claims and settlements and for NPs to be covered by ad- equate malpractice insurance. NAPNAP advocates that:

� All NPs should have access to affordable malpractice insurance. NAPNAP supports affordable insurance rates for NPs.

July/August 2015 11A

� Employers have a responsibility to provide malprac- tice insurance coverage to NP employees.

� NPs have the responsibility to understand the Nursing Practice Act and malpractice laws in the state(s) in which they are licensed and/or practicing.

� NPs have the responsibility to understand the mal- practice coverage requisites applicable to their provi- sion of professional health care services.

� NPs have an obligation to consider the role of license protection coverage as it relates to their malpractice insurance policy.

� NPs should obtain continuing education in risk as- sessment and reduction on a regular basis.

� NP programs should incorporate education related to risk assessment, liability, and malpractice insurance coverage.

� Research and data collection related to NP malprac- tice liability should continue and be published to im- prove NPs’ knowledge about malpractice.

� NPs should support legislation at the state and na- tional level to ensure malpractice insurance is afford- able and obtainable for all health care providers.

NPs have a responsibility to ensure that the malprac- tice insurance coverage applicable to their provision of professional health care services is sufficient to protect themselves and the individuals they care for. NAPNAP’s mission is to empower pediatric nurse practitioners and their health care partners to enhance child and family

12A Volume 29 � Number 4

health through practice, leadership, advocacy, educa- tion and research.

The National Association of Pediatric Nurse Practi- tioners would like to acknowledge the contribution of the Professional Issues Committee and the following members for their contribution to the revision of this statement: Kristin Hittle, MSN, RN, CPNP-AC, CCRN, Professional Issues Chair; Melanie Balestra, MSN, CPNP, JD; Mary Chesney, PhD, RN, CPNP, FAAN, NAP- NAP President; and Tracy Nichols, MSN, CPNP.

REFERENCES Balestra, M. (2012). The best defense for registered nurses and nurse

practitioners: Understanding the disciplinary process. Journal of Nursing Law, 15(2), 39-44.

Barry, P. (2006). Perspectives on private practice. Professional malpractice insurance and practicing within professional guide- lines. Perspectives in Psychiatric Care, 42, 201-203.

Buppert, C. (2007). Arguments for having your own insurance. The Journal for Nurse Practitioners, 3, 590-592.

Jordan, L. M., Quraishi, J. A., & Liao, J. (2013). The national practi- tioner data bank: What CRNAs need to know. AANA Journal, 81(2), 97-102.

LeBuhn, R., & Swankin, D. A. (2010). Reforming scopes of practice: A white paper. Retrieved from https://www.ncsbn.org/ ReformingScopesofPractice-WhitePaper.pdf

Liguori, R., & Jones, D. (2006). Report of the NAPNAP malpractice insurance survey: Do you know if you are covered? Journal of Pediatric Health Care, 20, 143-147.

Miller, K. (2011). Malpractice: Nurse practitioners and claims re- ported to the national practitioner data bank. The Journal for Nurse Practitioners, 7(9), 761-763, 773.

National Association of Insurance Commissioners. (2014). Medical professional liability insurance. Retrieved from http://www. naic.org/cipr_topics/topic_med_mal.htm

National Council of State Boards of Nursing. (2014). Nurse practice acts guide and govern nursing practice. Retrieved from https://www.ncsbn.org/npa-toolkit.htm

Journal of Pediatric Health Care