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If a stroke patient arrives within four and one-half hours of symptom onset, this means two things. One, your patient could be saved from a devastating disability if he or she is a candidate for treatment with thrombolytics.
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In January 2009, an emergency nurse and the nurse's hospital were found negligent for not making appropriate reassessments and failing to detect a worsening condition in a patient with a femoral arterial blockage. A $2.4 million verdict was returned.
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An injured nerve upon placement of an intravenous (IV) line, usually the radial nerve on the patient's dorsal wrist. A retained foreign body during IV removal, or fractured IV catheter upon removal. A misplaced Foley catheter, usually inflated in the ureter instead of the bladder.
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There is no question about it: ED nurses are more likely to be sued now than a decade ago.
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There is no question that ED overcrowding increases legal risks. "In a busy ED, communication is key to avoiding a lawsuit," says Debra A. Gray, RN, MSN, LNC, principal of Gray's Analysis, a Beaverton, OR, legal nurse consulting company.
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I remember when the Goldman myocardial infarction (MI) algorithm came out, quickly followed by a seven-button hand-held "calculator." It promised to reduce all decision-making regarding ED chest pain patients to seven yes or no questions. But when you looked into the mathematics, if you answered no or negative to all of the questions, it indicated a 4% chance of acute cardiac ischemia. So, what would you do with this information? Could you tell the patient that there was only a 4% chance of a heart attack, so it was OK to go home?
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Routine laboratory tests (RLT) and chest radiographs (CXR) are a source of considerable expense in the care of ICU patients.
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This study was carried out by the research group on quality improvement of the European Society of Intensive Care Medicine.
