The Health & Medicine Policy Research Group in Chicago recently released a report about changes in the state's healthcare industry. The market must react to shifts in demographics, state and federal health reform, and surging costs in delivering quality care. Nursing is among the most prevalent professions in the healthcare and may be poised to significantly expand its scope and role. Advanced practice nurses (APNs) include those trained as nurse practitioners, specialty clinical nurses, nurse anesthetists, or nurse midwives. The industry may benefit from these professionals in many ways, according to what is allowed by law. An APN may be capable of conducting evaluations, assessments, writing prescriptions and more. With the increased responsibility, there is likely a corresponding increase in medical liability.
The American Association of Nurse Practitioners sought to determine the incidence rates among APNs relating to actions of professional negligence and malpractice and found:
- Nurse Practitioners (NPs) had a rate of malpractice of 1.9%
- In malpractice cases roughly 37% are brought against physicians
- Roughly 3.1% of cases are brought against Physician Assistants (PAs)
Their report suggests that NPs have fewer negligence suits filed against them than other related professionals. Usage of APNs in aspects of practice traditionally conducted by a primary care physician (PCP) is largely motivated by a shortage of PCPs and the financial savings that can be attained.
Roughly 18 states allow NPs to practice independently, meaning without physician oversight. Maryland and D.C. are among those, while Illinois can be classified as a moderate state that “reduces” NP independence relative to others. A National Practitioner Data Bank (NPDB) report indicated that malpractice rates were no higher in states that allow for NPs to practice independently.
In the U.S., State Boards of Nursing are responsible for licensing, addressing complaints and more. State Nursing Boards have no jurisdiction involving matters of medical malpractice; rather, they occur exclusively in civil courts. Their primary goal is the protection of the public, and they seek to balance this core responsibility with an individual's right to practice in their selected occupation. In Illinois, the board takes action on matters involving the Nurse Practice Act, including:
- Errors such as a failure to properly document or a failure to adhere to drug administration requirements
- Mishandling or misusing controlled substances
- Boundary violations where a nurse receives a benefit at the expense of a client
- Physical or sexual misconduct or abuse
- Positive results found on background checks
The Nurses Service Organization (NSO) is a provider of professional liability insurance for nurses. They explain that nurses may be held liable for negligence when problems occur when they delegate tasks to others. This liability depends on if the nurse acted in a manner that a “reasonably prudent” nurse would, or if a failure to supervise or monitor delegated activity occurred. A key to preventing liability when delegating is to confirm that the individual is qualified to complete the task in a safe and accurate manner. This may be dependent upon their training, experience, and educational qualifications.