Take forward-looking approach in reducing nursing home liability risk

LETTER — Posted April 26, 2004

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Regarding "Tort crisis hits nursing homes" (Article, March 8): A number of steps can be taken to minimize the legal exposure in this area.

First and foremost, be sure to communicate directly with family members. Do not ask nursing home personnel to ask family members about clinical practice decisions such as the use of feeding tubes and medical interventions.

Second, family members tend not to be able to differentiate between negligent care and the aging process. This is particularly evident following a hip fracture or when a nursing home resident is unable to maintain nutrition because of cognitive or functional decline.

Third, direct the staff to notify you when significant changes in the resident's condition occur, such as the development of a pressure ulcer, weight loss, falls or behavioral issues.

Lastly, take time to read pertinent portions of the care plan, nursing monthly summaries, wound care flow sheets and dietitian's progress notes that ultimately impact upon your practice.

Since most nursing home malpractice actions involve pressure ulcers, malnutrition and falls, it is necessary to take proactive steps in addressing the needs of your residents as well as the education of their families.

Ilene Warner-Maron, RN,

Jeffrey J. Maron, DO, Media, Pa.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/04/26/edlt0426.htm.

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