Patient care recordkeeping key to cutting nurse med mal claims

Nursing professionals should carefully document patient care to avoid malpractice claims, which experts say are increasing in severity.

From 2020 to 2024, the average total incurred cost of malpractice claims involving nursing professionals increased by 12.5% to $236,749, according to a report released last month by the Hatboro, Pennsylvania-based Nurses Service Organization, a division of Aon Affinity, in collaboration with CNA HealthPro.

The percentage of closed claims above $750,000 has risen to 7.9% from 5% over the same period. Exceptionally high jury awards are on the rise across the U.S. and are affecting nurse malpractice claims, the report says.

Nursing specialties with the highest average paid indemnity claims in the report were obstetrics, surgical and home health care.

The share of med mal claims involving home health care has increased, as have the payments to resolve those claims, said Jennifer Flynn, risk manager for Nurses Service Organization.

Only about 10% to 11% of nurses nationwide work in home health care, yet that specialty accounted for 21.7% of closed claims, she said.

Malpractice claims involving home health care nurses average $301,031, a 39.3% increase since 2020, according to the report.

“There are unique risks in home health care” compared with nurses working in hospital settings, such as communication differences in an urgent situation, she said.

“Many times, you’re relying on calling 911 when you recognize those changes in the patient’s condition as opposed to calling a code or calling for an emergent situation in a more controlled setting,” she said.

Claims involving treatment and care accounted for the majority of malpractice allegations against nurses (56.2%), followed by allegations involving patients’ rights, abuse and professional conduct (18.2%). According to the report, 82.4% of the closed claims in the latter category involved falls.

Nurses are taking a larger role in patient care because of a shortage of doctors, said Gail Hennessey, product development and underwriting director at Berxi, part of Berkshire Hathaway Specialty Insurance.

Nurse practitioners, for example, have prescription authority in many states and no longer need a collaborating physician, Ms. Hennessey said.

Malpractice claims against nurses are increasing as more defendants are named in lawsuits, increasing the complexity and cost of defending claims, she said.

“Plaintiffs’ attorneys are looking for larger and larger settlements, so they’re naming everyone. It could be the nurse who just happened to be in the area, it could have been just an admin person,” she said.

Meticulous note-taking during treatment is essential, and nurses should stay up to date with continuing education and professional development to minimize exposure, Ms. Hennessey said.

Nursing professionals can differentiate their risk profile by understanding factors within their control and those that their organizations influence, said Julie Ritzman, senior vice president, patient safety and risk management at The Doctors Co., a med mal insurer.

Competence, training, adherence to protocols, clear and positive communication and ongoing attention to mental and emotional well-being are within nurses’ control, Ms. Ritzman said.

Institutional factors include policies, staffing levels, workload and equipment availability. “If you believe that these factors are compromised and are compromising patient safety, then you really need to advocate for yourself and your colleagues,” she said.

Nurses should participate in continuing medical education and professional development programs and use risk assessment tools to ensure they are following best practices, maintaining current knowledge and reducing both personal and systemic risks, Ms. Ritzman said.