2.50
Hdl Handle:
http://hdl.handle.net/10755/622144
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Legal and Ethical Accountability for Nursing Errors: Disclosure and Apology
Other Titles:
Nursing Ethics
Author(s):
Westrick, Susan J.
Lead Author STTI Affiliation:
Non-member
Author Details:
Susan J. Westrick, JD, CNE, Professional Experience: Susan J. Westrick, JD, MSN, RN, CNE is a nurse attorney and professor of nursing at Southern Connecticut State University in New Haven, and teaches theory and clinical courses for BSN, MSN and EdD students. Professor Westrick specializes in legal and ethical issues related to nursing and healthcare, and serves as an expert witness in malpractice cases involving standard of care issues, and the nurse’s duty to advocate for patients and to follow the chain of command. A frequent author and presenter on legal and nursing education issues, she has published a number of articles and book chapters, and is author of the second edition of “Essentials of Nursing Law and Ethics” (2014) Jones and Bartlett Learning, publisher. She is a past president of CT TAANA (Connecticut Chapter of The American Association of Nurse Attorneys), a longstanding member of the national TAANA organization and its education section Author Summary: Susan J. Westrick, JD, MSN, RN, CNE is a nurse attorney and professor of nursing at Southern Connecticut State University, who teaches courses for BSN, MSN and EdD students, and frequently speaks on legal and ethical issues related to nursing and healthcare. She has published articles, book chapters, and the text “Essentials of Nursing Law and Ethics” (2014). She is a member of the Connecticut and national chapters of The American Association of Nurse Attorneys
Abstract:

Purpose - The purpose of this session is to review the legal and ethical evidence bases for accountable disclosure of errors and apology by nurses, and to provide guidance on best practices for these disclosures.

Error disclosure and apology are evolving concerns for nurses who have increased exposure to liability. The Institute of Medicine (IOM) report To Err is Human brought national attention in the United States to the problem of medical errors and preventable injuries that occur every day (Institute of Medicine, 1999). According to this report, it is estimated that 98,000 patient deaths per year can be attributed to preventable medical errors, raising concerns about patient safety. One of the tenets of communication and patient safety is the ethical obligation to promptly disclose medical errors. Transparency is an integral component of providing safe and accountable care and a critical element of transparency is disclosure of harmful errors. This practice has been recommended by United States (U.S.) accrediting organizations and professional bodies. In 2001, the Joint Commission on Accreditation of Healthcare Organization (now called The Joint Commission) issued the first nationwide disclosure standards, requiring patients to be informed of all unanticipated outcomes of care (Weiss & Koch, 2012). In 2006, the National Quality Forum endorsed a new safe practice guideline on the disclosure of serious unanticipated outcomes to patients. Although these guidelines are not legal mandates, the recommendations of these well -known health care organizations comprise professional standards that could be used as evidence in malpractice cases or other legal challenges in the U.S.

In the United Kingdom (U.K.) there is a new law and guidelines for National Health Service (NHS) doctors and nurses that requires them to apologize to patients for mistakes (Merrifield, 2015). These guidelines, issued by the General Medical Council and Midwifery call for a “duty of candor” in disclosing medical errors. The International Council of Nurses (ICN) Code of Ethics for Nurses (2012) and the American Nurses Association (ANA) Code of Ethics for Nurses (2015) provide further support for error disclosure practices.

Yet even with these mandates and guidelines, barriers to disclosure exist, and error disclosure has been a subject of debate by healthcare professionals. Errors threaten a practitioner’s competency, adequacy, and self –esteem and may lead to employer or professional discipline (Westrick, 2014). Nurses also may not be aware of U.S. state apology statutes (laws) that protect some statements from use in civil lawsuits for negligence or malpractice. Two law cases involving physicians that apply apology laws are reviewed to illustrate these protections (Airasian, 2008; Davis, 2011). Nurses would be similarly protected as “health care practitioners” under the wording of the statutes applied in both cases.

Successful error disclosure programs in the U.S. and best practices for error disclosure such as the “Michigan Model” (Kalachalia, Kaufman & Boothman (2010) have made a difference in reducing liability claims. The Sorry Works! Coalition was formed in 2005 as an advocacy group that promotes apology for medical errors and fair compensation when appropriate to patients and families (http:/www.sorryworks.net/).The website provides training materials and toolkits to assist practitioners and organizations in the apology process. Additionally nurse educators are urged to include error disclosure content in nursing curricula as part of safety and quality education, since this is typically not a part of undergraduate or graduate courses for advanced practice nurses (Westrick & Jacob, 2016). Nurses continue to need support and guidance for specific aspects of error disclosure and apology to patients (Meyers, 2011).

Keywords:
Apology; Error; Legal; Ethical
Repository Posting Date:
25-Jul-2017 ; 25-Jul-2017
Date of Publication:
25-Jul-2017
Other Identifiers:
INRC17L12
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleLegal and Ethical Accountability for Nursing Errors: Disclosure and Apologyen_US
dc.title.alternativeNursing Ethicsen
dc.contributor.authorWestrick, Susan J.en
dc.contributor.departmentNon-memberen
dc.author.detailsSusan J. Westrick, JD, CNE, Professional Experience: Susan J. Westrick, JD, MSN, RN, CNE is a nurse attorney and professor of nursing at Southern Connecticut State University in New Haven, and teaches theory and clinical courses for BSN, MSN and EdD students. Professor Westrick specializes in legal and ethical issues related to nursing and healthcare, and serves as an expert witness in malpractice cases involving standard of care issues, and the nurse’s duty to advocate for patients and to follow the chain of command. A frequent author and presenter on legal and nursing education issues, she has published a number of articles and book chapters, and is author of the second edition of “Essentials of Nursing Law and Ethics” (2014) Jones and Bartlett Learning, publisher. She is a past president of CT TAANA (Connecticut Chapter of The American Association of Nurse Attorneys), a longstanding member of the national TAANA organization and its education section Author Summary: Susan J. Westrick, JD, MSN, RN, CNE is a nurse attorney and professor of nursing at Southern Connecticut State University, who teaches courses for BSN, MSN and EdD students, and frequently speaks on legal and ethical issues related to nursing and healthcare. She has published articles, book chapters, and the text “Essentials of Nursing Law and Ethics” (2014). She is a member of the Connecticut and national chapters of The American Association of Nurse Attorneysen
dc.identifier.urihttp://hdl.handle.net/10755/622144-
dc.description.abstract<p><strong>Purpose </strong><span>- The purpose of this session is to review the legal and ethical evidence bases for accountable disclosure of errors and apology by nurses, and to provide guidance on best practices for these disclosures.</span></p> <p>Error disclosure and apology are evolving concerns for nurses who have increased exposure to liability. The Institute of Medicine (IOM) report <em>To Err is Human</em> brought national attention in the United States to the problem of medical errors and preventable injuries that occur every day (Institute of Medicine, 1999). According to this report, it is estimated that 98,000 patient deaths per year can be attributed to preventable medical errors, raising concerns about patient safety. One of the tenets of communication and patient safety is the ethical obligation to promptly disclose medical errors. Transparency is an integral component of providing safe and accountable care and a critical element of transparency is disclosure of harmful errors. This practice has been recommended by United States (U.S.) accrediting organizations and professional bodies. In 2001, the Joint Commission on Accreditation of Healthcare Organization (now called The Joint Commission) issued the first nationwide disclosure standards, requiring patients to be informed of all unanticipated outcomes of care (Weiss & Koch, 2012). In 2006, the National Quality Forum endorsed a new safe practice guideline on the disclosure of serious unanticipated outcomes to patients. Although these guidelines are not legal mandates, the recommendations of these well -known health care organizations comprise professional standards that could be used as evidence in malpractice cases or other legal challenges in the U.S.</p> <p>In the United Kingdom (U.K.) there is a new law and guidelines for National Health Service (NHS) doctors and nurses that requires them to apologize to patients for mistakes (Merrifield, 2015). These guidelines, issued by the General Medical Council and Midwifery call for a “duty of candor” in disclosing medical errors. The International Council of Nurses (ICN) Code of Ethics for Nurses (2012) and the American Nurses Association (ANA) Code of Ethics for Nurses (2015) provide further support for error disclosure practices.</p> <p>Yet even with these mandates and guidelines, barriers to disclosure exist, and error disclosure has been a subject of debate by healthcare professionals. Errors threaten a practitioner’s competency, adequacy, and self –esteem and may lead to employer or professional discipline (Westrick, 2014). Nurses also may not be aware of U.S. state apology statutes (laws) that protect some statements from use in civil lawsuits for negligence or malpractice. Two law cases involving physicians that apply apology laws are reviewed to illustrate these protections (Airasian, 2008; Davis, 2011). Nurses would be similarly protected as “health care practitioners” under the wording of the statutes applied in both cases.</p> <p>Successful error disclosure programs in the U.S. and best practices for error disclosure such as the “Michigan Model” (Kalachalia, Kaufman & Boothman (2010) have made a difference in reducing liability claims. The Sorry Works! Coalition was formed in 2005 as an advocacy group that promotes apology for medical errors and fair compensation when appropriate to patients and families (http:/www.sorryworks.net/).The website provides training materials and toolkits to assist practitioners and organizations in the apology process. Additionally nurse educators are urged to include error disclosure content in nursing curricula as part of safety and quality education, since this is typically not a part of undergraduate or graduate courses for advanced practice nurses (Westrick & Jacob, 2016). Nurses continue to need support and guidance for specific aspects of error disclosure and apology to patients (Meyers, 2011).</p>en
dc.subjectApologyen
dc.subjectErroren
dc.subjectLegalen
dc.subjectEthicalen
dc.date.available2017-07-25T18:49:54Z-
dc.date.available2017-07-25T18:52:02Z-
dc.date.issued2017-07-25-
dc.date.accessioned2017-07-25T18:49:54Z-
dc.date.accessioned2017-07-25T18:52:02Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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