Please respond to the following write ups Address some of the problems, if any, with the current malpractice legal system related to malpractice with references.
Advanced practice nurses (APN) are a part of an increasingly complex health care system and currently twenty-eight states allow full practice authority for APNs (American Association of Nurse Practitioners [AANP], 2021). The APN faces similar professional liability risks as the primary care physicians because they have the responsibility to protect their patients and themselves by practicing within the scope of practice that is mandated by the state statute, rules, and regulations (Heuer et al., 2019).
According to Joel (2018) table 29.1 and 29.3, in Arizona, the APN had a total of 103 medical malpractice payments from 1990-2014, while the physician had a total of 5,194 during the same time. The highest claim number for the APN was 11 in the years 2007 and 2011 and the highest number of claims for the physician was 307 in 2003. Tables 29.2 and 29.4 from Joel (2018) show the APN had a total of 21 adverse actions taken against them in Arizona from 1990-2014, while the physician had 3,337 adverse actions reported during the same time in Arizona. The difference in claims may be related to the number of practicing physicians compared to practicing nurse practitioners and the patient-provider encounters. Brock et al. (2017) discuss that three-quarters of malpractice counts against APN are due to diagnosis or treatment-related events while the physician has half of their malpractice counts for the exact reason. There could be a difference in claims in adverse events because all adverse licensure actions, clinical privilege actions are mandatory for physicians to report while it is voluntarily reported by APNs (Joel, 2018). In addition, medical errors and near misses are often and not report and not all significant allegations will result in an award, so they are not reported to the NPDB (Brock et al., 2017).
Practice safety is the expectation for all providers, and malpractice is a serious issue. Malpractice is considered practice that is improper, negligent or criminal (Dictionary.com, 2021). Exposures for malpractice in Advanced Practice Nursing include: financial risks, civil and criminal risks, and licensure risks (Joel, 2018). Similar risks are assumed by physicians and physician assistants as well. The unfortunate reality is that mistakes happen and all providers must protect themselves with best practices, and malpractice insurance.
In Joel (2018), the data for malpractice suits were significantly lower for Nurse Practitioners as compared to physicians. While there may be many reasons for this, one important factor for this may be that up until 2021, APRNs in the state of Massachusetts were not allowed independent practice. It is thought that the rates of malpractice claims against APRNs may rise in conjunction with independent practice (Gardnier et al., 2015). Sweeney et al., (2017) states that malpractice claims against APRNs are increasing over time.
The majority of claims against nurse practitioners is diagnosis related, and a majority involved independent practice (Sweeney et al., 2017). Avoiding malpractice claims and suits involves excellence and precision in care along with other strategies and skills such as: good communication, good documentation, knowing your limits as an NP, not allowing others to dictate care, and prompt responses to patients (Brown, 2014).
Nursing is a patient-centered endeavor at its core. Advanced practice nursing is no different, and quality outcomes are a function of that care. Malpractice can harm the care by raising the cost of care and thereby potentially reducing patient access to care. The malpractice system may also affect treatment by inducing providers to practice defensive medicine or avoid reporting incidents (Renkema, 2014). As APRNs broaden their influence and practice, it is imperative to be aware of the pitfalls, and gain strategies for the best, safest delivery of care.