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At least 253 records · Page 14Linked to original sources
PubMed2004

Injuries associated with regional anesthesia in the 1980s and 1990s: a closed claims analysis.

BACKGROUND: The authors used the American Society of Anesthesiologists Closed Claims Project database to identify specific patterns of injury and legal liability associated with regional anesthesia. Because obstetrics represents a unique subset of patients, claims with neuraxial blockade were divided into obstetric and nonobstetric groups for comparison. METHODS: The American Society of Anesthesiologists Closed Claims Project is a structured evaluation of adverse anesthetic outcomes collected from closed anesthesia malpractice insurance claims of professional liability companies. An in-depth analysis of 1980-1999 regional anesthesia claims was performed with a subset comparison between obstetric and nonobstetric neuraxial anesthesia claims. RESULTS: Of the total 1,005 regional anesthesia claims, neuraxial blockade was used in 368 obstetric claims and 453 of 637 nonobstetric claims (71%). Damaging events in 51% of obstetric and 41% of nonobstetric neuraxial anesthesia claims were block related. Obstetrics had a higher proportion of neuraxial anesthesia claims with temporary and low-severity injuries (71%) compared with the nonobstetric group (38%; P <or=0.01) and a lower proportion of claims with death or brain damage and permanent nerve injury compared with the nonobstetric group (P <or= 0.01). Cardiac arrest associated with neuraxial block was the primary damaging event in 32% of obstetric and 38% of nonobstetric neuraxial anesthesia claims involving death or brain damage. Eye blocks accounted for 5% of regional anesthesia claims. CONCLUSION: Obstetric claims were predominately associated with minor injuries. Permanent injury from eye blocks increased in the 1990s. Neuraxial cardiac arrest and neuraxial hematomas associated with coagulopathy remain sources of high-severity injury.

Adult↗
PubMed2001

Psychiatric crises and emergency admissions.

Emphasize safe practice to avoid legal liability when evaluating individuals in psychiatric crisis. Test your knowledge with the following questions, then check your answers at http://www.nursingmanagement.com.

Commitment of Persons with Psychiatric Disorders↗
PubMed2002

Restraint use in acute and critical care settings: changing practice.

Reduction of physical restraint use in the acute and critical care setting is a complex issue. Ethical considerations, regulatory and professional standards, legal liability concerns, healthcare team members' knowledge and attitudes, and unit culture and practice traditions must all be considered. Restraint reduction programs may use a process improvement format that engages the support of the organization's leadership. Specific interventions for restraint reduction, such as understanding the meaning of a patient's behavior, using a team approach, and involving the family can be evaluated and modified for application in the acute and critical care setting. Successful initiatives to decrease the use of restraint in this setting require an understanding of the many factors that support and oppose this practice.

Critical Care↗
PubMed1997

Don't test, do sell: legal implications of inclusion and exclusion of women in clinical drug trials.

This article explores the historic underpinnings of the exclusion of women from clinical drug trials, identifies recent developments, and examines legal implications for women with epilepsy and for others. Distinguishing stakeholders and their interests may lead to policies that better serve all. Past and present statutory, regulatory, and judicial frameworks were reviewed, as well as legal, medical, and historical commentary. Traditionally, researchers and manufacturers have not tested particular drugs on women. Physicians and pharmacists routinely prescribe and sell these same medications regardless of gender. Only since 1993 have females been more likely to be included in clinical drug trial subject pools. The impact of past and future practices on health care provision and legal liability remains unknown. A policy of "Don't test, do sell" will not protect women with epilepsy or would-be defendants. At this time the most effective shields will involve procurement of informed consent as well as testing of both women and men. In the long run, tort, health care, and regulatory reform will best serve all interested persons. Inclusion of women in clinical drug trials has become a how question, not an if one.

Anticonvulsants↗
PubMed2006

Disclosing conflicts of interest in clinical research: views of institutional review boards, conflict of interest committees, and investigators.

Strategies for disclosing investigators' financial interests to potential research participants have been adopted by many research institutions. However, little is known about how decisions are made regarding disclosures of financial interests to potential research participants, including what is disclosed and the rationale for making these determinations. We sought to understand the attitudes, beliefs, and practices of institutional review board chairs, conflict of interest committee chairs, and investigators regarding disclosure of financial interests to potential research participants. Several themes emerged, including general attitudes toward conflicts of interest, circumstances in which financial interests should be disclosed, rationales and benefits of disclosure, what should be disclosed, negative effects of and barriers to disclosure, and timing and presentation of disclosure. Respondents cited several rationales for disclosure, including enabling informed decision making, promoting trust in researchers and research institutions, and reducing legal liability. There was general agreement that disclosure should happen early in the consent process. Respondents disagreed about whether to disclose the amounts of particular financial interests. Clarifying the goals of disclosure and understanding how potential research participants use the information will be critical in efforts to ensure the integrity of clinical research and to protect the rights and interests of participants.

Attitude of Health Personnel↗
PubMed2006

Law & psychiatry: "depressed? Get out!": dealing with suicidal students on college campuses.

This column examines college and university policies under which students who manifest suicidal ideation are barred from campus, usually by immediate suspension or mandatory withdrawal. Such policies, which appear to be increasing on U.S. campuses, generally reflect administrators' fears of legal liability if students commit suicide on campus. The author reviews two recent cases-Schieszler v. Ferrum College and Shin v. Massachusetts Institute of Technology-that have created a climate of fear among administrators and suggests ways to change blanket policies so that students at low risk of suicide will not be barred from campus and will seek and obtain appropriate treatment.

Adolescent↗
PubMedDate not supplied

Malpractice and the neonatal intensive-care nurse.

Perinatal nursing has become a specialty vulnerable to litigation, due to parents' high expectations of health care providers' ability to monitor for adverse events and intervene appropriately to prevent harm. When a neonate is injured during the perinatal period, a frequent response is to look for someone to blame. Neonatal nursing is considered a specialty area, requiring specialized knowledge and training. By adhering to recognized and accepted internal and external policies, neonatal nurses will uphold the standard of care set for their area of practice and avoid legal liability.

Certification↗
PubMedDate not supplied

Maximizing profit and endangering health: corporate strategies to avoid litigation and regulation.

Corporations and industries use various tactics to obscure the fact that their products are dangerous or deadly. Their aim is to secure the least restrictive possible regulatory environment and avert legal liability for deaths or injuries in order to maximize profit. They work with attorneys and public relations professionals, using scientists, science advisory boards; front groups, industry organizations, think tanks, and the media to influence scientific and popular opinion of the risks of their products or processes. The strategy, which depends on corrupt science, profits corporations at the expense of public health. Public health professionals can learn from this strategy how to effectively build scientific and public opinion that prioritizes both good science and the public health.

Advisory Committees↗
PubMedDate not supplied

Generalist and specialist nurses: caring for a patient with a stoma.

This article looks at the legal liability of a specialist nurse in relation to the general nurse who has invited her advice on the care of the patient. It considers the law relating to negligent advice and the concept of vicarious liability. It also looks at the dangers which could result from the specialist nurse taking over basic care of the patient as general nurses become deskilled.

Community Health Nursing↗
PubMed1998

Dental insurance and the periodontal patient.

Approximately one-half of the United States population is covered by a dental benefit plan. One-fifth of that group is covered under various types of managed care contracts, and this number is said to be increasing by 15% to 20% per year. However, dentists report that these plans have not had a major impact upon their practices. Only 6% of patients were covered by them, and only 2% of gross receipts were derived from them. Periodontists surveyed were divided in their opinions about how managed care has affected their practices. This paper discusses these changes, particularly with regard to income, referral patterns, treatment decisions, and ethical and legal liability.

Decision Making↗
PubMed1995

Legal considerations in treating the injured athlete.

This article is intended to inform physical therapists about legal considerations impacting the practice of sports physical therapy. Our objective is to generate an awareness of these issues to enhance the quality of physical therapy provided to injured athletes and to minimize potential legal liability. Three areas in which physical therapists who treat injured athletes need to be particularly careful are: 1) providing treatment designed to enable continued play with an injury before it is fully healed, 2) informing an athlete of the potential health risks of continued athletic activity in his or her physical condition, and 3) evaluating and advising an athlete concerning his or her ability to resume athletic activity. Based on the parallels between industrial rehabilitation and sports physical therapy, the authors propose that consensus objective criteria and guidelines should be established to assist therapists in advising referring physicians and athletes whether return to play is appropriate under the circumstances.

Athletic Injuries↗
PubMed1994

Use of registry employees can pose legal problems.

In view of the potential legal liability to which a recipient entity can be exposed when using registry employees, some care must be taken in drafting registry contract services and in modulating the recipient entity's behavior towards the registry personnel. The following steps should generally be taken by health care establishments purchasing registry services to minimize such exposure: (1) Ensure that the registry treats its personnel as employees and complies with all applicable employment law obligations, including state and federal employment tax requirements, workers' compensation laws, and any state law wage and hour requirements in the recipient's state. (2) If using an out-of-state registry, make sure that the registry also has workers' compensation insurance in the recipient's state and complies with that state workers' compensation laws. (3) Make sure that termination decisions regarding registry employees are not made for reasons that violate any federal anti-discrimination laws. (4) Provide in the registry agreement for full indemnification by the registry to the recipient. (5) Ensure that the registry is solvent and has adequate insurance to honor its indemnification obligation. (6) Obtain a warranty from the registry that it carefully screens all of its employees before hiring them. (7) Expressly state in the registry agreement that the registry has the right to discipline and supervise the personnel it refers. (8) Do not reject registry personnel for reasons that would be improper with respect to the facility's own employees, e.g., race, sex, age, religion, disability, etc.

Contract Services↗
PubMedDate not supplied

Client-centred standards: risk implications for boards and management.

The author argues that the Canadian Council on Health Services Accreditation standards have acquired the status of law and that, therefore, there may be an increased risk of legal liability inherent in the use of the council's new client-centred standards. As survey teams focus less on structure and more on the individual client, the potential for instances of substandard care to be uncovered and documented as part of the survey process escalates.

Accreditation↗
PubMed1998

Do healthcare managers have an ethical duty to admit mistakes?

Historically, healthcare organizations have been reluctant to admit mistakes because of potential legal liability. Admitting mistakes and taking corrective and compensatory action may reduce the likelihood of a lawsuit and, if a lawsuit is lost, may reduce the punitive damage award. Financial consequences involve admitting mistakes and incurring the associated compensatory costs or not admitting mistakes and incurring associated compensatory and punitive damages for the mistakes that are discovered later. Ethical consequences revolve around managers' duty to patients, the healthcare organization, and themselves and their families.

Ethics, Institutional↗
PubMed1998

Introduction of a new medical procedure: a novel approach.

Before it is permitted for general use, a newly developed drug or medical device must undergo a series of pre-clinical testing and clinical trials to prove safety and efficacy. However, new medical procedures--even highly sophisticated and ethically controversial ones, such as organ transplants and I.V.F. do not require any clearance from regulatory authorities. This is an undesirable situation, which can be corrected by limiting legal liability for those who opt to perform new medical procedures as part of clinical trials. By this means we shall encourage a more prudent and better regulated introduction of new technologies into medical practice.

Clinical Trials as Topic↗
PubMed2000

Complementary healthcare practices and the implications for nurse practitioners.

Complementary, or alternative, healthcare practices are being incorporated into approximately 4 out of 10 Americans' daily health practices. The out-of-pocket expense for such healthcare use was estimated at $21.2 billion in 1997. There are many different forms of complementary health care that nurse practitioners (NPs) must be aware of when evaluating and forming plans of care with their patients. NPs must develop and incorporate interview techniques to obtain this information from their patients to prevent potential interactions. NPs must also be aware of their lack of experience with complementary healthcare practices and the legal liability of incorporating these practices into their practice without appropriate preparation in their use.

Clinical Competence↗
PubMedDate not supplied

Legal issues confronting the occupational physician.

Occupational physicians are frequently participants in a legal arena in which the interests of the patient are in conflict with those of the patient's employer. What is best for the patient may be viewed as financially burdensome or damaging to the employer. Pressures may be brought to bear upon the doctor, who is also concerned with furthering business relationships with the employer, to take action that is inimical to the patient's well-being. This article addresses legal liability and ethical responsibility in three situations: (1) when limitations or constraints are placed upon the physician's professional judgment in treating the patient; (2) when demands are made upon the physician to release medical information regarding a patient; and (3) when the physician is asked to perform a medical evaluation for purposes of litigation.

Confidentiality↗