Nursing
SkyPapers
medical_practitioners_ppt_2.pptxRecognizing the Role of Adhering to the Standard of Care to Avoid Malpractice
Challenges to Nursing practitioners.
Non-compliance.
Patient not talking.
Patient refusal to take drugs.
Patient not turning up for check-ups.
As per our case, the patient shows non-compliance by not talking(Ryan, D. H. 2014). If the patient does not show any corporation too the Nursing Practitioners, it becomes hard for the providers to provide the desired service.
2
Causes of Non-compliance.
Excessive alcohol or drug use.
Social factors.
Cultural factors.
Financial issues.
Denial
Dementia.
Depression.
This factors make the patient become non-compliant and make the nursing practitioners in an awkward position as they cannot efficiently and adequately manage the patients (Ryan, D. H. 2014). If the patient hails from a community that perceives doctors as learned people, they may develop inferiority complex and expect the nurses to know their problem and carry out the appropriate diagnosis.
3
Effects of non-compliance.
Patient:-
Not taking the right prescriptions.
Patient not undergoing through the required diagnosis.
Adverse health effects.
Death.
Patient non-compliance leads to 10% death of patients per year (Buppert, C. 2015). Some patients may at times not take the right dosage, this will lead to the disease pathogens developing resistance and become incurable. Due to this the final result may be death.
4
Legal implications for Standard of Care Nursing Practitioners.
Bring out the duty the providers have to the patients.
Create a provider-patient relationship.
Importance of the legal implications.
Proper execution of provider services.
Customer satisfaction
Its contract between provider and patient.
For one to apply the legal implications he has uphold the standard of care of the nursing practitioners(Ryan, D. H. 2014). For better service delivery and customer satisfaction, a code of ethics is given to the Nursing Practitioners. Making it the legal binding liability to them. It is a voluntary relationship that arises when the patient requests for medical information or treatment.
5
Establishment of provider-patient relationship.
The relationship can be built through:-
Office visits.
Casual discussions.
Telephone calls.
Guidelines indicate to the practitioners to embrace a good rapport with the patients in order to build trust in them and remove non-compliance(Buppert, C. 2015). During such interactions the provider is supposed to give the best service possible and build confidence in the patient to provide the service. Through this the customer can easily keep away the act of non-compliance.
6
Standard of care provided by the Nursing Practitioners.
It can be provided through the following ways:-
Skill
Reasonable.
Diligence
Ordinary care.
His standards of care if not adhered to can lead to negligence. Which leads to a legal theory of malpractice(Buppert, C. 2015). The practitioners must uphold the best skills that they have acquired from experience and education. The education that they undergo trains them to be reasonable and diligent. The ordinary care is acquired as one gains experience in the medical field.
7
Key elements of malpractice
The nurse had a duty to the patient.
The nurse breached the duty.
A patient injury occurred due to breach of duty.
Damage occurred.
Then four elements must be carefully considered in determining a medical practitioner malpractice occurrence(Morales, K. 2012). Avoiding questions and answering questions indirectly can lead to malpractice. This is to determine whether the nurse committed an act or omitted carrying out a duty that eventually caused harm to the patient. Failure to order proper testing is a good example of breach of duty. A nurse may be on duty and consequently have a duty to a patient and commit an action or omission during the service providence, and it may not constitute into malpractice if the omission or action had no harmful effects to the patient(Morales, K. 2012).
8
Collaborative Practice Agreements
Formal written statement addressing the parameters of collaborative practice.
Mutually agreed upon by Nursing Practitioners and licensed physician.
Supervisory contracts between the physicians and NPs.
The practitioners have to consult a lawyer who is familiar with contract law, partnership law and relative law with Nursing Practitioners in setting up any kinds of relationships being complex issue. As laws call for supervisory contracts with the physicians, this prohibits physicians from contracting with self-employed Nursing Practitioners(Stelmach, E. I. 2015). It helps to get the concern that the physicians employed by nurse practitioners maintain their objective despite the possibility that the NP could fire them for unpopular opinion(Stelmach, E. I. 2015).
9
Nursing Practitioners Preparedness.
Through educational preparedness it assumes:-
Responsibility
Accountability.
Assessment.
Diagnosis
management
The Nursing Practitioners are go through good and comprehensive education that is aimed at health promotion and better patient problems managements. This includes the use and presciprtion of pharmacologic and non-pharmacologic interventions(Stelmach, E. I. 2015).
10
Parameters of Nursing Practitioners Practice.
Methods of Patient Care.
Documentation.
Diagnostic/lab Requests.
Prescriptions.
Healthcare Institution Admissions and Privileges.
Patient Care Coverage.
Cancellation of Collaborative Agreement.
The Nursing Practitioners have responsibilities that maintain competency and carry out their responsibilities with regard to the Texas licensing Board. Both the Nursing Practitioners and the Physicians have to work in collaboration in order to give the patients the best care(Stelmach, E. I. 2015). From documentation all through to documentation; both parties have to show adherence to governing guidelines.
11
Texas Medical Board.
Violation of guidelines include:-
Practice Inconsistent with Public Health and Welfare.
Negligence in performing medical services.
Failure to treat patient with regard to accepted standard of care.
Failure to use proper diligence in profession.
Improper utilization review.
Termination of patient care without reasonable notice to patient.
Relating to Standards for Physicians Practicing Complementary and Alternative Medicine for use by human beings or does not meet the standards for off-label use, unless an exemption is obtained(Stelmach, E. I. 2015). Any practice of dismissing the patient, should be given an adequate amount of time to get another healthcare provider or could lead to liability.
12
Patient Dismissal.
The provider-patient relationship can be terminated at any time.
The relationship can be terminated only if:-
Cessation of the medical necessity that brought the relationship
Voluntary discharge by the patient.
The patient my have a cause of action for abandonment if the dismissal is without reasonable notice, a physician unilaterally discontinue treatment when progressive medical treatment is necessary(Stelmach, E. I. 2015). The physician is obliged to continue giving the required progressive medical attention until the causes of termination listed above as met in part or full(Stelmach, E. I. 2015).
13
Cause for Patient Dismissal
Patient non-compliance.
Incase of surgery, when postoperative services are not needed.
Incase of obstetricians, during postpartum.
Incase of transfer of physician to other department.
The main cause for dismissal of patients is non-compliance among the patients(Stelmach, E. I. 2015). Despite the patient non-compliance the physician must consider the patients medical status(Stelmach, E. I. 2015). For the surgical patients, the physician has to give the assistance until the patient does not need the postoperative care. If the physician is transferred to another department the patient is not abandoned until a replacement physician is found.
14
Process of Patient Dismissal.
Counselling of the patient.
Documentation of patient statements.
Send dismissal letter to the patient.
Termination process.
For non compliant patients the physicians should first consider setting up a counselling session with the patient(Stelmach, E. I. 2015). The whole process should be documented, for future referencing incase of a lawsuit. If the noncompliance persists a dismissal letter is sent to the patient and a copy kept by the physician. Finally the termination process should come along after sending the termination letter by informing the office staff especially the scheduler to refrain from receiving appointments from the patient after the termination date(Stelmach, E. I. 2015).
15
References.
Buppert, C. (2015). What is a nurse practitioner? In Nurse practitioner’s business practice and legal guide (5th ed.) (1-16, 33). Burlington, MA: Jones & Bartlett. Commonwealth of Virginia. (2016). Administrative code. Retrieved from www. http://law.lis.virginia.gov/admincode/title18/agency85/chapter140/section150/
Morales, K. (2012). The 4 elements of medical malpractice in nursing. Retrieved from http://www.nursetogether.com/4-elements-medical-malpractice-nursing
Skolnik, N. S., & Ryan, D. H. (2014). Pathophysiology, epidemiology, and assessment of obesity in adults. The Journal Of Family Practice, 63(7 Suppl), S3-S10. Stelmach, E. I. (2015). Dismissal of the Noncompliant Patient: Is this What We Have Come to? The Journal for Nurse Practitioners, 11(7), 723-725.
Stelmach, E. I. (2015). Dismissal of the Noncompliant Patient: Is this What We Have Come to? The Journal for Nurse Practitioners, 11(7), 723-725.
