AUSTIN, Texas — Nurse practitioners need to be encouraged to collaborate with other health care practitioners and provided with training in certain procedures to help reduce professional liability claims against them, according to Lauran Cutler, New York-based risk control consulting director for CNA Healthcare, a unit of CNA Financial Corp.
Giving a presentation Monday during the American Society for Healthcare Risk Management's annual conference in Austin, Texas, Ms. Cutler presented data from nearly 1,900 professional liability claims against nurse practitioners that were covered and closed by CNA between 2007 and 2011.
Diagnosis issues main cause of litigation
About 43% of those professional liability claims were related to diagnosis problems, such as failure to diagnose or a delay in diagnosis, Ms. Cutler said. Treatment and care management-related problems and medication prescribing issues were also prevalent in claims against nurse practitioners, representing 29.5% and 16.5% respectively of CNA's professional liability claims during the study period.
Failure to diagnosis infections and abscesses that led to sepsis and failures or delays in diagnosing cancer represented significant portions of claims against nurse practitioners in CNA's data, Ms. Cutler said. She said such cases should provide a lesson in encouraging nurse practitioners to partner with other health care providers who could help identify medical conditions in treatable stages.
“Maybe we need to help nurse practitioners and the collaborating physicians that they're working with establish some protocols and guidelines as to when additional testing is needed, when they should and must collaborate, when consultations are needed,” Ms. Cutler said.
Training in wound procedures
Ms. Cutler noted that a small number of claims involved nurse practitioners performing minor procedures that went awry, such as the suturing of a hand injury that resulted in disfigurement and disability.
She noted that health care systems should be sure nurse practitioners are properly trained to do such work.
“We don't always think of nurse practitioners getting involved in procedures and wounds,” Ms. Cutler said. “So we need to be aware that people are hiring these nurse practitioners to work and do things that they may not have the clinical skills, experience and competency to do.”
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