We’ve all been there…on the guilty end of making a mistake when it comes to caring for our patients. Whether you prescribed an antibiotic to which the patient was allergic, performed a less than adequate procedure or misdiagnosed a medical condition, nurse practitioners and physician assistants aren’t perfect. Mistakes are to be expected. We are, after all, human. But, when working with patients even the smallest of errors can have major consequences. What steps should you take when you totally screw up?
According to the Journal of Patient Safety, between 210,000 and 440,000 hospitalized patients each year suffer from some type of medical error that contributes to their death. That makes medical errors the third-leading cause of death in America, resulting in higher mortality than accidents or strokes. Many times, medical errors can be attributed to the systems and processes in place within the hospital or institution. Other times, negligence of the medical provider is to blame. Whatever the cause of the error, reacting appropriately is essential for the health outcome of affected patients and to ensure the best possible legal outcome for the provider.
If you make a medical error as a nurse practitioner or physician assistant, here are the steps you must take in response.
1. Admit the error
Many healthcare providers assume that letting the patient and family know of a medical error puts them in a bind. Providers expect that patients may be unlikely to allow the practitioner to take steps to correct the error given apparent incompetence. And, healthcare providers predict that admitting a mistake could lead to a medical malpractice lawsuit. Data shows otherwise.
A study from the University of Michigan indicates that the more upfront and honest healthcare providers are in the face of a medical error, the less likely patients and families are to reactively sue. So, if you make a mistake as a nurse practitioner or physician assistant, fess up.
2. Fill your team members in
Errors must be communicated to the rest of the patient care team so that any necessary modifications to the care plan can be made. Admitting your mistake to colleagues isn’t easy. Failure to do so, however, can result in increasingly negative patient outcomes and mismanagement of the patient’s medical condition.
3. Report the mistake according to protocol
Your hospital likely has a protocol in place for reporting clinical errors. Let your supervisor know of the mistake and complete appropriate associated paperwork in a timely manner. Adhering strictly to reporting guidelines is essential. First, this alerts administrators to systems and protocols that may need to be modified to prevent similar errors in the future. Second, this shows your compliance helping keep you in good standing with your employer. Finally, adhering to protocol puts you in a better place legally should litigation arise as a result of the incident.
4. Document, document, document
Documenting the events of the error in a timely manner is essential. Documentation must be accurate and complete including the date and time of the error, the location, a description of the incident, the severity, presumed cause or circumstances and the immediate actions taken in response. Keep documentation objective. Be thorough. This written record will be the basis by which your actions are judged as well as the background from which further care of the patient is dictated.
5. Remain legally aware
Facing a medical malpractice lawsuit is a nurse practitioner or physician assistant’s greatest fear. The process is nerve wracking, costly and potentially public. If you are later approached with questions regarding your error, or if your error is significant, seek legal counsel early on. This ensures you don’t make any errors in communication that could be used against you in future litigation. Staying on point legally isn’t adversarial, it’s simply smart.
Have you ever made a mistake as a nurse practitioner or physician assistant? What were the implications?
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