Reply separately to two of my peer’s posts (See attached peer’s posts, post#1 and post#2).
INSTRUCTIONS:
Reply to two of your classmates—from different states—after reviewing the information provided in your initial post and comparing your state stats. Address some of the problems, if any, with the current malpractice legal system related to malpractice.
Your responses should be in a well-developed paragraph (300-350 words) to each peer, and they should include evidence-based research to support your statements using proper citations and APA format!
Note: DO NOT CRITIQUE THEIR POSTS, DO NOT AGREE OR DISAGREE, just add new informative content regarding to their topic that is validated via citations.
- Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.
- Minimum of 300 words per peer reply.
Background: I am a Registered Nurse, I work in a Psychiatric Hospital (Crisis & Stabilization).
My POST
State of Florida
According to Joel’s textbook, APRNs including CNSs, NAs, CNMs, and NPs in Florida between the years of 1990-2014 had 571 reports of suits and settlements filed as per the National Practitioner Data Bank by state and year (Joel, 2018). In comparison, physicians, including MDs and DOs in Florida, recorded 23,291 reports of suits and settlements. More so, there were several adverse actions taken against the Adverse Practitioner Registered Nurses and Physicians, including loss of clinical privileges, DEA actions, or exclusion from medical or professional societal groups’ participation. The APRNs recorded 77 reports of adverse cases as compared to 5,769 reported cases in Florida between the same time frame (1990 – 2014) (Joel, 2018).
There is a vast difference between the number of reports of suits and settlement and reports of adverse cases between the APRNs and the physicians; MDs and DOs with the MDs recording the highest number of cases in both cases. So, what factors contributes to these differences. First, the dramatic differences are brought by the less population of NP’s in the 90s as compared to today. However, the discrepancies in lawsuits and adverse actions between the APRNs and MDs in terms of medical malpractice might have been attributed by the roles of medical doctors in the hospital settings. Most of the differences occur because physicians, especially MDs and DOs, attend various patients, and they are more vulnerable to mistakes. The medical malpractice involves misdiagnosis or delayed diagnosis, negligent lapse in a patient’s care, or failure to treat. More so, medical doctors are more involved in prescribing medications for the patients than the APRNS, thus this could result in medication errors. Medication errors may result from the wrong prescription of medications, dosage, or prescribing inappropriate interactions. Consequently, medical doctors are more involved in surgeries than the APRNs leading to surgical errors that lead lawsuits (Dos Santos Martins, 2020).
The smaller number of lawsuits reports among APRNs is also due to they spend more time face to face with their patients. Having a close relationship with the patients enables the APRNs to be open, respectful, honest, and improving the communication with the patient’s family members. It is conceived that the patient would less likely sue the APRNs when they feel that that they are more caring and professional. Also, the APRNs have improved their interactions with the patients, and they have avoided offering their opinions about the patient’s conditions since they are aware, they might be sued for making a medical diagnosis. More so, the APRNs can also be sued if they only act beyond their defined scope of practice or when their MD’s inadequately supervise them.
Malpractice lawsuits have a substantial effect on the patient’s access. First, the patient would be re
POST # 1 CARRIE
State of California
In 2017 a report was published that analyzed the rates of malpractice reports and adverse reactions and compared physicians, physician assistants (PA’s) and nurse practitioners (NP’s) and found that NP’s have the lowest rate of malpractice payments followed by PA’s and then physicians (Brock et al., 2017). However, when comparing malpractice allegations PA’s have the highest allegation rate followed closely by NP’s and then physicians (Brock et al., 2017). Lagasse (2018) highlighted the growing profession of NP’s and that by 2025 almost a third of the family practice workforce will include NP’s, and that NP’s can lead to improved productivity. In addition, it was found that NP’s and physicians share similar liability risks but found that many of the claims can be a result of failing to maintain the scope of practice for the NP or inadequate supervision by a physician (Lagasse, 2018). The most frequent malpractice allegation against NP’s is failure to diagnose, and accounts for almost a third of the claims (NSO, 2019). Hoffman and Wang (2019) found that NPs are more likely to be named as co-defendent with a physician and noted that the number of cases is trending upwards.
According to data compiled by Joel (2018) the rate for reports of adverse events and malpractice suits and settlements were a rate around 1%, whereas for a physician the rate is closer to 35% and 12% (p. 450). In my state of California, the rate of malpractice settlements from 1990 to 2014 was near the top with 225 suits and settlements, only Florida (571), New York (372), Texas (331) and Pennsylvania (244) were higher (Joel, 2018, table 29.1). In addition, the rate of payments was also higher in California, Florida, New York, and Pennsylvania (Joel, 2018, table 29.3). This makes sense when one considers that those are the most populous states (IPL, 2021), and would have more NP providers and larger populations being served (Kaiser Family Foundation, 2021). However, when one looks at the number of adverse actions reported against NPs from 1990 to 2014 California is on the lower end with 35 and some states such as Alabama having 284, Washington with 157, Oklahoma with 156, Tennessee with 149 (Joel, 2018, table 29.2). In Alabama, a NP must have a collaborative agreement with a physician and the physician must be on site for 10% of the time and review 10% of the charts and interestingly are not recognized as primary care providers (Thrive Advanced Practice, 2013). One possibility for the higher rate of adverse actions could be a result of less supervision or an agreement that goes outside the scope of the NP practice. In malpractice cases in California the patient must prove that the provider misdiagnosed or failed to diagnose and illness, made a mistake during surgery, provided the wrong medication or dosage or failed to deliver an infant in stress in a timely fashion (Nield Law Group, 2
POST # 2 ERIKA
State of Utah
Medical malpractice is something that no provider wants to deal with, but it is an unfortunate reality for some. Utah has fewer reported suits and settlements than many other states, but the number of cases has still increased for both advanced practice nurses (APRNs) and physicians over the years. In Utah, advanced practice nurses reported 33 suits and settlements from 1990 to 2014, while physicians reported 2,317 (Joel, 2018). It is likely that physicians reported more malpractice suits than APRNs because there are more physicians than APRNs and physicians tend to take on more complex patient cases. Overall, the number of malpractice suits where APRNs have been named as the primary defendant is low at only 2% (Buppert, 2021).
Malpractice suits can have an unfortunate effect on patients’ access to care. When a clinician is caught up in a legal issue, they may to miss work to attend hearings and to meet with lawyers which takes away time from them seeing patients. Malpractice suits can also lead to stricter regulations on all clinicians-MDs, APRNs, and PAs which can limit where they practice, particularly APRNs and PAs. APRNs often help fill a gap in healthcare in rural settings but having stricter regulations can limit the number of APRNs who want to practice in a rural setting. This is unfortunate as APRNs who practice in rural settings have been shown to provide safe, quality care (Yang et al., 2021).
References
Buppert, C. (2021). Nurse Practitioner’s Business Practice and Legal Guide (7th edition). Jones & Bartlett Learning.
Joel, L. A. (2018). Advanced practice nursing: Essentials for role development (4th ed). F. A. Davis Company.
Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2020). State Nurse Practitioner Practice Regulations and US Health Care Delivery Outcomes: A Systematic Review. Medical Care Research and Review, 1077558719901216.
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