Which of the following is an example of nursing malpractice?
A. The nurse administers penicillin to a patient with a documented history of allergy to the drug. The patient experiences an allergic reaction and has cerebral damage resulting from anoxia. B. The nurse applies a hot water bottle or a heating pad to the abdomen of a patient with abdominal cramping. C. The nurse assists a patient out of bed with the bed locked in position; the patient slips and fractures his right humerus D. The nurse administers the wrong medication to a patient and the patient vomits. This information is documented and reported to the physician and the nursing supervisor.
Option A is a case of nursing malpractice. In this example, the nurse made an error (administering penicillin) that could have been avoided with the available information. This error then immediately caused a serious health problem (cerebral damage). Option D is definitely an error, but it didn’t cause a serious health problem – vomiting once is unpleasant, but not serious enough to count as malpractice.
In option C, it’s the reverse: the broken humerus is a serious health problem, but it wasn’t caused by an error. The nurse was doing the right thing by keeping the bed locked. In option B, we don’t have enough information to say whether it was an error, or whether that error caused any serious health problems.
The nurse administers penicillin to a patient with a documented history of allergy to the drug. The patient experiences an allergic reaction and has cerebral damage resulting from anoxia.
The three elements necessary to establish a nursing malpractice are nursing error (administering penicillin to a patient with a documented allergy to the drug), injury (cerebral damage), and proximal cause (administering the penicillin caused the cerebral damage). Applying a hot water bottle or heating pad to a patient without a physicians order does not include the three required components. Assisting a patient out of bed with the bed locked in position is the correct nursing practice; therefore, the fracture was not the result of malpractice. Administering an incorrect medication is a nursing error; however, if such action resulted in a serious illness or chronic problem, the nurse could be sued for malpractice.