Nurse practitioners (NPs) in senior care are at the forefront of one of healthcare’s fastest-growing and most critical sectors. Today, more than 56 million Americans are aged 65 and older, a number that’s expected to grow to 82 million by 2050.
While the demand for skilled providers to meet senior healthcare needs is growing, serving this population comes with liability risks. Managing older adults typically involves balancing multiple medications and preventing adverse events in a patient population that’s by it’s nature in decline.
Incidents like falls, medication errors and failure to advocate for a patient’s safety all leave nurse practitioners in senior care vulnerable to malpractice claims.
By protecting yourself with best practices and professional liability insurance coverage, NPs in senior care can enjoy a career that’s as rewarding as it’s essential.
Consider the top risks nurse practitioners in senior care face, along with actionable strategies to mitigate them.
1. Slips and falls
Falls are a common medical risk in senior care, which can lead to costly claims. About one in four adults in the U.S. (28%) age 65 and older report falling each year, resulting in about 36 million falls each year.
Staffing shortages have made the risk of falls even higher. Nurse practitioners working in senior care must proactively assess patients’ fall risks, such as age, mobility and medications.
Mitigating the risk of falls
Assessing patients’ risk factors and creating fall prevention strategies can decrease the risk of falls. These strategies include continuous fall prevention training and safety measures such as bed alarms or bed rails.
When a fall does occur –– which it inevitably will as a nurse practitioner in senior care –– having a fall response protocol can help you avoid a malpractice claim.
Train direct service staff to support patients with cognitive impairment
Patients with cognitive Alzheimer’s and dementia are at a higher risk of injury. You can proactively prevent falls by using chair and bed alarms and having more staff on hand during sundowning when patients are more agitated.
Risk 2: Medication errors
Older adults often require multiple medications, increasing the risk of medication errors. Administering medications safely and efficiently as a nurse practitioner in senior care requires experience and best practice protocols.
The consequences of not following the protocol became all too well known in the conviction of a Vanderbilt Hospital ICU nurse after a medical error that led to the death of her patient in May 2022.
Reduce your risk by preventing medication mistakes
To mitigate dangerous and costly medication mistakes, reinforce the five rights of medication administration as a standard of care. Using medication reconciliation tools and encouraging patients and caregivers to report any side effects promptly can further reduce risk.
Establish a clear medication policy for your organization
Reinforce your medication administration policy by regularly educating your staff on the importance of adhering to the policy. Conduct ongoing training on safe medication practices and procedural guidance on how practitioners give the right medications.
Encourage staff to report any mistakes or errors to supervisors immediately.
Establish protocols for tracking medication errors. This helps you identify patterns and take steps to prevent errors. Technology like barcode scanning or automated dispensing cabinets can reduce human error.
When errors do occur, you should report them to your insurance carrier, even if a malpractice claim hasn’t been made.
Risk 3: Poor documentation
Incomplete documentation poses significant risks for nurse practitioners in senior care. In a medical malpractice claim, showing that you adhered to standard operating procedures significantly increases the likelihood of a favorable outcome.
“When a lawsuit arises, the worst scenario is when you can’t produce clear patient care records. This makes it a pretty easy case for the plaintiff to win,” says Jeff Schmidt, an executive producer at HUB International.
Reduce your risks with thorough, prompt documentation
Best documentation practices are important for patients’ continuity of care and safety. It also helps clinicians show evidence of due diligence in case of a lawsuit.
Be accurate and complete
Ensure all patient visit entries are precise and comprehensive. Missing details can be construed as negligence.
Include timestamps
You should also include timestamps in your documentation –– a feature available in most EMRs.
Risk 4: Employee risks
Senior care has particularly high employee turnover. Paying competitive salaries and building a culture that supports company loyalty can reduce staff turnover. Still, even the top healthcare places of work struggle to fill positions.
High turnover requires careful planning to support your staff and maintain patient safety.
Background checks
Conduct thorough background checks during the hiring process to ensure employees are qualified, have proper credentials and have a history of integrity.
Training
New staff in an employee shortage are sometimes thrown into the work without adequate training. Take the time to provide ongoing training to staff to ensure staff maintain standardized care.
Risk 5: Working outside of practice scope
Staffing shortages and the demands of senior care can leave some providers working beyond their scope of practice. It’s not uncommon in senior care facilities for certified nursing assistants (CNAs) to fill the role of nurses.
Many nurses have years of knowledge based on experience. Still, making a diagnosis or calling in a prescription is outside the scope of their practice license.
Any misdiagnosis from a provider that leads to harm is a risk. If that misdiagnosis comes from someone working out of practice scope, the risk is significantly higher.
Reduce your risk by preventing your staff from working outside of scope of practice
Following are ways Gigi Acevedo-Parker, a nurse practitioner and licensed attorney at HUB International, recommends protecting patients’ health and reducing your risk:
Develop protocols for patient care
Many healthcare workers, like experienced nurses, have vast knowledge beyond their scope of practice. However, following explicit protocols developed by a physician ensures they adhere to their scope of practice.
Stay educated on any changes in regulations or laws related to scope of practice
Each state has regulations for every clinical license. Clinicians usually receive notice by email and mail when these changes occur. To ensure your organization stays compliant, regularly review state policies and procedures.
Learn more about CM&F Group’s medical malpractice insurance. CM&F Group offers professional liability insurance to over 150 types of healthcare professionals. All our coverage options are available online, allowing our clients to obtain liability insurance coverage within minutes.
