Missouri Nurse - January 2022

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Missouri Nursing News January, February, March 2022
Think like an expert witness to avoid...continued from page 5
appropriate actions after a fall can help mitigate further
injury. Both prevention and post-fall follow up not only
benefits patients, but also reduces the risk of a lawsuit.
Was there liability?
If a patient falls, an expert witness will likely want
to know the answers to the following questions
(developed by Patricia Iyers) when deciding if liability
may exist:
• Was the patient identified as being at risk for
falls? How was that risk communicated to
others?
• Were measures implemented to prevent falls?
• Approximately how soon was the individual
found after he had sustained a fall?
• What was done at the time of the fall?
• Was the patient appropriately monitored after
the fall to detect injuries?
• What did the assessment (including vital signs)
reveal?
• Did the nurse communicate the findings to the
patient’s provider?
• Were X-rays ordered and performed?
• Was there an injury? If so, how soon was it
treated?
• If the patient hit their head, was the chart
reviewed to determine if mediations included
an anticoagulant? If on anticoagulant, was this
information communicated to the provider so
head scans could be performed to check for
cranial bleeding?
• Was there a change in mental status after the
fall?
• Were additional assessments and monitoring
done as follow up?
• Was the patient’s risk for falls reassessed after
the fall and the plan of care revised to minimize
the risk of future falls?
Article by: Georgia Reiner, MS, CPHRM, Senior Risk
Specialist, Nurses Service Organization (NSO)
RESOURCES
Bono MJ, Wermuth HR, Hipskind JE. Medical malpractice.
StatPearls. 2020. www.ncbi.nlm.nih.gov/books/
NBK470573.
Centers for Disease Control and Prevention. Important facts
about falls. www.cdc.gov/homeandrecreationalsafety/
falls/adultfalls.html.
Centers for Disease Control and Prevention. STEADI:
Materials for healthcare providers. 2020. www.cdc.gov/
steadi/materials.html.
CNA, NSO. Nurse Professional Liability Exposure
Claim Report: 4th Edition. 2020. www.nso.com/
nurseclaimreport.
Dykes PC, Adelman J, Adkison L, et al. Preventing falls in
hospitalized patients. Am Nurs Today. 2018;13(9):8-13.
https://www.myamericannurse.com/preventing-fallshospitalized-patients.
Iyer P. Legal aspects of documentation. In: KG Ferrell, ed.
Nurse’s Legal Handbook. 6th ed. Wolters Kluwer; 2015.
Van Voast Moncada L, Mire GL. Preventing falls in older
persons. Am Fam Physician. 2017;96(4):240-247. https://
www.aafp.org/afp/2017/0815/p240.html.
Disclaimer: The information offered within this article
reflects general principles only and does not constitute legal
advice by Nurses Service Organization (NSO) or establish
appropriate or acceptable standards of professional conduct.
Readers should consult with an attorney if they have specific
concerns. Neither Affinity Insurance Services, Inc. nor NSO
assumes any liability for how this information is applied in
practice or for the accuracy of this information.
This risk management information was provided by
Nurses Service Organization (NSO), the nation's largest
provider of nurses’ professional liability insurance coverage
for over 550,000 nurses since 1976. The individual
professional liability insurance policy administered through
NSO is underwritten by American Casualty Company of
Reading, Pennsylvania, a CNA company. Reproduction
without permission of the publisher is prohibited. For
questions, send an e-mail to service@nso.com or call 1-800-
247-1500. www.nso.com.
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