Ethical-legal Principles and Dilemmas in Health Care

Case Study: Malpractice Action Brought by YP   YP is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.  During the evening shift the infusion pump began to beep. The RN found that the IV was dislodged and discontinued the infusion, notified the physician and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done.   The documentation in the medical record indicates that there was an infiltration to the IV. Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient is alleging that because of this, she is no longer able to perform as a musical conductor.  The risk manager had noted when doing chart reviews over the last 3 months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings, and nights then coming back and working the evening shift. The risk manager also noted a pattern of using float nurses to several units. Using the information from the case study below, discuss the following issues from the perspective of an Nurse practitioner:  Standards of care – what were the standards of care that were violated? Who was responsible for the violations?  In your role as an practitioner, what risk management steps needs to be taken before or after the incident to alleviate the issue? Possible Resources Anselmi, K. K. (2012). Nurses’ personal liability vs. employers’ vicarious liability. MEDSURG Nursing, 21(1), 45–48. Lachman, V. (2016). Ethics, law, and policy. Ethical concerns in medical-surgical nursing. MedSurg Nursing, 25, 429-432. Matt, S. (2012). Ethical and legal issues associated with bullying. Journal of Nursing Law, 15, 9-13. Watson, E. (2014). Nursing malpractice: costs, trends, and issues. Journal of Legal Nurse Consulting, 25, 26-31. Westrick, S. J. (2016). Nursing students’ use of electronic and social media: Law, ethics, and e-professionalism. Nursing Education Perspectives, 37, 16-22.

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