Identifying Legal Aspects of the Case
According to Joint Commission Resources (2007), “the individual performing surgery should be the one who marks the surgical site…” (p. 25). While marking the site to be operated, the health care professional should consult and inform the patient about the marking before the operational process in order to ensure him/her that the marked site is right and avoid medical errors in future. Importantly, in case the surgeon does not mark the site, the person who did that should inform about the procedure and deliver all necessary information about the site (Joint Commission Resources, 2007, p. 26).
Finally, there should be a delegation that appoints a specific person to mark the site. Any responsibility connected with this procedure must be applicable to nursing law and regulations. With regard to these statements, certain legal aspects have been violated and even neglected by the health care professionals.
Taking the Universal Protocol into the deepest consideration, there are certain rules and procedures that have not been performed by the surgeon. In particular, there was a failure in negotiating to patient concerning the marked site as Ms W never had an opportunity to confirm the marking and talk with the practitioner who marked the site. Second, according to the Universal Protocol (n. d.), “The procedure is not started until all questions and concerns are resolved” (p. 1). In fact, there was no any “Time-Out” before the procedure and this was, apparently, one of the gaps accepted by the professionals. It also prevented the team members from indicating the correct site and from accomplishing the procedure in a proper manner.
Analyzing the Pitfalls of Ethical Standards of Nursing As Presented in the Case
While carrying out specific medical procedure, health care professionals should establish proper communication with their patients to avoid any ambiguities in the course of treatment. Even if the medical error has happened, the main task of nurse professionals is to provide the patient with full disclosure of the process where apologizing should be the first step. However, apologizing is not the only thing that should be followed after a medical error occurs. It is obvious that patients are eager to know the reasons for the malpractice as well as outcomes of this mistake. Negligence in this situation can lead to the patients’ emotional distress (Gallagher, 2009, p. 671).
According to Joint Commission Resources (2009), “Rights & Ethics addresses issues such as patient privacy, confidentiality and protection of health information, advance directives (as appropriate), organ procurement, use of restraints, informed consent for various procedures, and the right to participate in care decisions” (p. 292). In means that Ms W should have been warned about the all stages and nuances of the procedure beforehand.
Nurses should also have asked for the patients’ consent and confirmation of the procedure because the patient has the right to take an active part in decision-making. Failure to meet the patient’s concerns as well as negligence of patient’s right led to the expected outcomes. In addition, the surgery team also failed to hold responsibility for the mistakes because the practitioner that had marked the site never explained and apologized for his/her mistake. The mistakes made by the nursing staff cause patient’s emotional stress because the accomplished procedure distressed Ms W greatly.
Mistake in Communication and Interaction between the Provider and the Patient As Presented in the Case
Relying on the scenario presented in the case, the nurse professionals failed to follow both legal and ethical principles of patient care and organizational behavior. First of all, the doctors behaved unprofessionally while disclosing information to the patients. The way the information was disclosed caused even more concerns and uncertainties about patient’s physical state. Second, everything, except for apologies that are also in question, has been neglected, including failure to ask a patient for the informed consent before the procedure, demonstrating the marked site to the patient as well as lack of coordination between the team members before and in the course of the operation.
Though the patient received a full disclose of information about her treatment and about the mistakes made, there is an urgent necessity to make it safer and less stressful for clients. For instance, there are explicit examples of wrong disclosure information delivered by the surgeon. It is inadmissible to exaggerate the fact, but submit them in a more neutral and formal way to eliminate stress situations.
Legal and Empirical Implications for Disclosing and Apologizing for Medical Errors
Information privacy is the main pillar of the nursing practice. Health care professionals should carefully sort information before delivering it to the patient. Therefore, the providers should thoroughly discuss these issues to receive the informed consent concerning which information about the patient can be reported and disclosed in order to avoid harm to patients.
There are essential legal, professional, and ethical reasons for disclosing medical errors to patients, but still it remains a very challenging thing for health care providers to do. Many physicians recognize the necessity to take responsibility for educating themselves about the character and nature of errors and gaining experience and skills to cope with the disclosure process properly (Joint Commission Resources, 2007, p. 74).
Such policies will contribute greatly to the quality of services and patient safety. Nevertheless, most health care professionals avoid information disclosure because of the fear of the litigation process. The difficulty of disclose also lies in the systematic barriers established by a medical culture that does not encourage the errors sharing. In addition, many professionals also afraid of disclosing the error due to the lack of knowledge about the errors as well as the consequences it will have for the patient’s health.
Proposed Solutions for Eliminating the Pitfalls of Disclosing Medical Errors
The challenges of disclosing medical errors and apologizing are often explained by lack of physicians’ education which discourages the improvement of patient safety and service quality. In this respect, physical training and education are essential for eliminating the existing problems. Particular attention should be paid to certain education areas and specialties. First of all, there should be medical error definitions for the health care providers to easily operate those, if necessary.
Second, the nurse professionals should be aware of human factor while delivering information about malpractice and reporting the mistakes. Error disclosure to patients should be carried out with patient’s cultural and social context bearing in mind (Joint Commission Resources, 2007, p. 75). Finally, a more systemic approach should be worked out for reporting errors as it will contribute greatly to the development of more advanced models of errors elimination. It is also worth saying that careful planning and distribution of resources provide more effective strategies for educating physicians and providing a safer and healthier environment for patients.
Reference List
Gallagher, T. H. (2009). A 62-Year-Old Woman with Skin Cancer Who Experienced Wrong-Site Surgery. Review of Medical Error. JAMA. 302(6), pp. 669-677.
Joint Commission Resources (2007). Compliance Strategies for the Universal Protocol. US: Joint Commission Resources.
Joint Commission Resources (2009). Standards for Ambulatory Care. US: Joint Commission Resources.
The Joint Commission (2011). The Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery. Web.