Patient filed a lawsuit for neglicent what do you think??

[Roqueyari]

Hello everyone, Iam a nursing student with little experince and looking for the opinions of those with more experience. I need your help. I've being asked to decide on a lawsuit where the patient filed this lawsuit after developing bedsores and decubitus ulcers while in the hospital. The expert witness did agree that the ulcers first appeared while in the hospital. But, the nurses documented that the patient was turned every 2 hours. Is this possible? The big questions is why this happened then? where there a deviation from the standards of care in this case? what are your thoughts thanks yari

[HouTx, BSN, MSN, EdD]

Sounds like a very interesting assignment.

You may want to explore the evidence. I recall attending a symposium several years ago in which a nurse researcher (presenting her study) had concluded that pressure ulcer development was not always a sign of nursing negligence, since there are some physiological conditions (e.g., cachexia) that give rise to pressure ulcers despite good nursing care. If nothing else, you may be able to present a logical argument.

[Roqueyari]

Hello Houtx, and thank you for your prompt response. Very interesting indeed your comment on your experience. But yes as i am learning in nursing there is no absolutes. Although i was more prone towards thinking there was a deviation on the nurses documentation not being accurate somehow. The case is not presented in too much details. Only that the documentation was done and standards of care were supposedly met.

[RiskManager]

Speaking as the person who does malpractice claims defense for a living, several potential issues come to mind:

1. From where was the patient admitted? For example, was she admitted from a SNF with areas of skin breakdown already?

2. Is there anything in the patient's history or clinical presentation that put her at greater or lesser risk of skin breakdown? If greater, should she have been on a higher level of skin precautions?

3. Is the charting on an electronic health record? If so, does the audit trail or metadata of the EHR support that documentation was indeed being done every two hours, or did the staff sit down at end of shift and document several two hour checks at once?

4. Are there any potential witnesses either to the documentation or the actual patient checks? For example, did the patient have a family member in the room with them? Does that person have anything to say about the checks being done?

5. If areas of skin breakdown were noticed, what response was done by the nursing staff? Was the attending provider promptly notified? Did the attending provider come to observe? If so, when? Did the attending provider write any orders germane to the skin breakdown?

6. Does the patient have any physiological conditions that could have caused the skin breakdown independent of any nursing actions?

So these are some ideas just off the top of my head. Good luck with your assignment.