Since the year 2000, the delivery of care has become the responsibility of the whole team.
Negligence is “failure to provide such care as a reasonably prudent & careful person would use under similar circumstances”.- Improper medication; wrong dose, wrong time, wrong medication.
- Failure to notify the physician.
- Improper use of equipment
- Miscommunication
- Failure to supervise the patient.
In the good old days of malpractice cases, doctors and the hospitals were seldom spared, in today’s times there have been limited instances where only the nurses were held liable for the harm to the patients.
Five ways by which one can prevent this.
1. Video surveillance; the video cameras should not be used only as a post mortem. They have to be used to look at infection control practices, time of medication given, handing over & communication.
2. Real-life simulation; for years we have been doing theory classes and there has been a marginal improvement in the negligence cases. Real-life simulation may be the better way where the nurses can develop their analysing skills, increase the speed of execution & realise the price of procrastination.
3. Weekly appraisal; there should be a dashboard for each nurse showing her skills, leadership, adhering to the provided rules, and ability of communication, as a scale which can move either way. This will determine his or her training needs, which can be addressed appropriately.
4. Technology; the game-changer. AI should be applied in the identification of the need for intervention which should come as a reminder on whatever screen the nurse is using. Data for each scenario should be put to use ensuring pop-ups come at regular intervals reminding of tasks that are overlooked.
5. Checklists; one cannot overemphasise the role of these in preventing harm. Dr. Atul Gawande of Boston Children should be considered for Noble prize in medicine or literature for this masterpiece. Checklists should form the basis of the above interventions. The adherence to the checklist should be considered as the holy bible of patient care.
With healthcare making its mark as the biggest employer of the future we cannot afford people to shy away from choosing to work in acute care with the fear of being implicated in a malpractice case. Also with home care & remote care growing the need for reliance on nurses is a forgone conclusion. The lack of trained doctors cannot be filled overnight. We have to evolve a system where zero tolerance for harm to a patient becomes a norm.
Dr. Sachin Jhawar
Apex Hospitals
