Introduction
A 52-year-old patient visited the emergency department of a hospital complaining of blurred vision and numbness in their hand. They were diagnosed by Nurse A with a transient ischemic attack and their symptoms quickly resolved (Nurse Case Study, n.d.,). However, a later examination by another nurse, B, revealed slurred speech, confusion, and weakness on the right side. These symptoms were reported to the emergency department and the doctor was contacted, but the neurologist did not examine the patient for over an hour. By that time, it was too late to administer tPA, a treatment for stroke. The patient’s symptoms worsened, and they were eventually diagnosed with a full stroke. As a result, they experienced partial paralysis of their arm, aphasia, mild cognitive impairment, and foot drop.
The patient filed a lawsuit alleging negligence on the part of the hospital staff for failing to timely diagnose and treat the stroke. The plaintiff argued that the stroke was caused by a clot that traveled to the brain and could have been treated with tPA. The hospital staff argued that tPA would not have been beneficial and that the stroke was caused by a circulatory obstruction due to a dissection of the left internal carotid artery. The case was settled for $4 million at the end of the plaintiff’s presentation of evidence at trial.
Impact of Legal Issue
This legal case highlights the importance of timely and accurate diagnosis and treatment in nursing practice. Nurses have a duty to provide competent care to their patients and to follow established protocols and standards of practice. In this case, the failure to diagnose and treat the patient’s stroke had serious consequences for the patient, including partial paralysis, aphasia, and cognitive impairment. This case also emphasizes the importance of thorough and accurate communication among healthcare professionals. There was a discrepancy between the initial examination of the patient by the doctor and nurse “A” and the later examination by nurse “B.” This miscommunication may have contributed to the delay in diagnosis and treatment.
Regulations, Laws, and Standards and Their Impact
There are several regulations, laws, and standards that pertain to the issue of timely and accurate diagnosis and treatment in healthcare, including:
- The Standard of Care: This refers to the level of care that a reasonably competent and skilled healthcare professional would provide under similar circumstances (Hoskins et al., 2018). If a healthcare professional fails to meet the standard of care, they may be found negligent in a legal action.
- Medical Negligence: Medical negligence occurs when a healthcare professional fails to provide care that meets the standard of care and as a result, a patient is harmed (Ozaras and Abaan, 2018). Nurses may be held liable for medical negligence if they fail to competently diagnose and treat a patient’s condition.
- HIPAA: The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the privacy of patients’ personal and medical information (Ozaras and Abaan, 2018). HIPAA requires healthcare professionals to maintain the confidentiality of this information and to only share it with authorized individuals.
- State Nursing Practice Acts: Each state has its own Nursing Practice Act, which outlines the scope of practice for nurses in that state and sets forth the standards that nurses must follow in their practice. These acts may include provisions related to the diagnosis and treatment of patients.
The impact of these regulations, laws, and standards is to ensure that healthcare professionals provide competent and appropriate care to their patients and to protect the privacy and confidentiality of patient’s personal and medical information. If these regulations, laws, and standards are not followed, healthcare professionals may face legal consequences and may damage the trust of their patients.
Risk-Mitigation Techniques
There are several risk-mitigation techniques that nurses can use to help prevent legal issues related to the timely and accurate diagnosis and treatment of patients. One important technique is to obtain informed consent from patients before providing any treatment or procedures. This involves fully explaining the risks, benefits, and alternatives to the patient and ensuring that the patient understands their options before proceeding. By obtaining informed consent, nurses can help to ensure that patients are fully informed about their care and can make informed decisions about their treatment.
Another important technique is to follow established protocols and standards of practice for diagnosing and treating patients. This includes following evidence-based guidelines and seeking guidance from more experienced colleagues when needed (Heinen et al., 2019). By following established protocols and standards, nurses can help to ensure that they are providing competent and appropriate care to their patients. Effective communication is also crucial in mitigating legal risks in nursing practice. Nurses should ensure that they communicate effectively with other members of the healthcare team and share all relevant information about a patient’s condition. This includes accurately documenting observations and reporting any changes in the patient’s condition to the appropriate healthcare provider.
Conclusion
There are several actions that nurses can take to increase compliance with these regulations, laws, and standards. One action that nurses can take is to stay informed about current guidelines and best practices for diagnosing and treating patients. This includes reading professional literature and attending continuing education courses. By staying up to date on the latest developments in their field, nurses can ensure that they are providing care that meets current standards and guidelines (Ozaras and Abaan, 2018). Nurses also should fully explain the risks, benefits, and alternatives to the patient and ensure that the patient understands their options before proceeding. By obtaining informed consent, nurses can help patients to be informed about their care and make decisions regarding their treatment.
References
Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of Advanced Nursing, 75(11), 2378-2392.
Hoskins, K., Grady, C., & Ulrich, C. M. (2018). Ethics education in nursing: Instruction for future generations of nurses. OJIN: The Online Journal of Issues in Nursing, 23(1), 1-4.
Nurse Case Study: Failure to timely diagnose and treat stroke. (n.d.). NSO. Web.
Ozaras, G., & Abaan, S. (2018). Investigation of the trust status of the nurse–patient relationship. Nursing Ethics, 25(5), 628-639. Web.