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What happens if a dialysis nurse takes my patient off the med/surg floor without my knowledge or consent, begins his treatment and this patient has a complication — who is responsible?

Friday January 11, 2013
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Question:

Dear Nancy,

What happens if a dialysis nurse takes my patient off the med/surg floor without my knowledge or consent, begins his treatment and this patient has a complication — who is responsible? Is it my responsibility to follow my patients to other parts of the hospital? I did follow this patient and suggested a course of action that would have prevented the complication. The dialysis nurse did not follow my suggestion, but I didn't push it because I considered the patient his at that moment. Whose call was it?

Kendra



Nancy Brent replies:

Dear Kendra,

When you handoff a patient to another nurse and service, it is essential that the handoff information be complete, informative and up-to-date, so the patient is not put at risk. An excellent resource to review on handoffs is: Friesen, White and Byers' chapter in the Agency for Healthcare Research and Quality's 2009 text, “Patient Safety and Quality: An Evidence-Based Handbook for Nurses.” Their chapter, chapter 34, can be accessed at http://www.ahrq/gov.

A nurse providing handoff information is responsible if the information provided is not complete, informative and up-to-date. Therefore, if a patient injury occurred, the nurse could be named in a lawsuit alleging he or she as negligent in not providing necessary information that contributed to the patient's injury.

In your situation, you did not get the opportunity to provide handoff information and you followed the patient to the dialysis unit to hopefully prevent any risk to the patient — you did try and alleviate the non-handoff procedure that did not occur. Most likely, in the situation you briefly described, you did the best you could under the circumstances and liability would not be assessed against you if a suit were filed.

Because dialysis is a procedure with many, many risks associated with it (see, for example, “Hemodialysis Administration: Strategies To Ensure Safe Patient Care,” Pa. Safety Advisory 7(3) 2010, 87-96. (Available at www.patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2010/Sep7(3). A transfer to the dialysis unit should not occur without the patient's nurse being informed and a handoff taking place.

You might want to discuss this with the nurse supervisor on your unit, so that it does not happen again, either to you or your fellow staff nurses.

Regards,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.