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week 9 response 2023 |

week 9 response 2023 |

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Reply to at least two of your classmates—from different states if possible—after reviewing the information provided in the initial post and comparing your state stats. Address some of the problems, if any, with the current malpractice legal system related to malpractice.
Please refer to the Grading Rubric for details on how this activity will be graded and incorporate these guidelines in your discussion. The grading for the number of reply posts is based on individual Discussion Board instructions. If the rubric indicates a different number for reply posts, you will not be graded down as long as you have followed the reply post instructions.
For this assignment to be considered complete, you must address all the prompts—including how malpractice suits affect patient access to care, comparing APRN to MD adverse events in your state, noting what differences there are, and discussing why there may be differences—by Day 3 and reply to two classmates, addressing some of the problems with the current malpractice legal system by Day 7.
Note: My state is Massachusetts’s 
(Reply) Response 1
This was a little shocking to see the numbers for adverse events for APRN. In Arizona for 2022 there were 474 reported adverse events compared to 352 in 2018 (NPDB, 2023). According to U.S. Bureau of Labor Statistics, Arizona has 3,068 licensed nurse practitioners (2023). The adverse events have gradually increased since 1990. When looking at malpractice and adverse events for MDs the numbers are definitely greater.  In 2022 there were 6,979 medical malpractice and 5,263 adverse events for MD/Dos (NPDB, 2023). There about 10,069 active physicians in Arizona (AAMC, 2023). Based on this information there is a corollary between malpractice and adverse events number of practicing providers. In the study by Myers, Sawicki, Heard, Camargo & Mort, that claims against APRNs for diagnosis-related allegation were lower which is contributed to APRNs without physician supervision see les complex, lower risk patients (2020). The study also pointed out that the difference in amount of claims could also be because not all states allow APRNs to practice independently so when the APRNs are under the physician the claim will name the physician instead. Another disparity that could directly affect claims reported for APRNS is that APRNS often work for a hospital and the hospital pays the claim (Myers, Sawicki, Heard, Camargo & Mort, 2020). I also feel that we should have the information about the individual claims because I would like to know how many are actually negligence or need of education and which ones are just “money grabbing” claims. Malpractice suits obviously affect patients in the immediate safety factor but it has far reaching effects. Providers can lose confidence therefore referring patients to interventionists which are more expensive for the patient (Myers, Sawicki, Heard, Camargo & Mort, 2020). This also means the provider will order more diagnostic imaging/tests when uncertain of patient’s presentation which again drives health care costs up (Myers, Sawicki, Heard, Camargo & Mort, 2020). I absolutely believe providers need to be held responsible for negligence but I think that sometimes “harm” is very subjective and it really comes down to sympathetic jurors. I wish there was more concrete objective evidence required in order to prove “harm.” Malpractice claims can ruin a provider’s livelihood as well as their personal wellbeing. As a nurse we were always taught in school that there are two types of nurses, the ones who made medication errors and the ones who will. This terrified me especially given the nurses that have been issued jail time for this type of mistake. I am positive that any provider would feel awful if they made a mistake that resulted in patient harm but then to be further injured by losing your practice, license or freedom.    
Association of American Medical Colleges. (2023). Arizona physician workforce profile. https://www.aamc.org/media/34106/download
Myers, L. C., Sawicki, D., Heard, L., Camargo, C. A., & Mort, E. (2020). A description of medical malpractice claims involving advanced practice providers. Journal of Healthcare Risk Management, 40(3), 8–16. https://doi.org/10.1002/jhrm.21412
National Practitioner Databank. (2023). The npdb – data analysis tool. npdb.hrsa.gov. https://www.npdb.hrsa.gov/analysistool/
U.S. Bureau of Labor Statistics. (2023). Nurse practitioners occupation employment and wage statistics. bls.gov. https://www.bls.gov/oes/current/oes291171.htm#st
(Reply) Response 2
The purpose of this post is to compare advanced practice registered nurse (APRN) adverse events and malpractice claims to medical doctors (MD) in Ohio, identify the differences, explain why there is a difference, and discuss how malpractice suits affect patient access to care. In 2021, out of the national estimate of 234,690 nurse practitioners, Ohio employed 10,210 nurse practitioners that practice with restrictions (U.S. Bureau of Labor Statistics [BLS], 2022). In addition, out of 256,670 physicians nationwide, 14,620 practice in Ohio (BLS, 2022). Malpractice claims against APRNs in Ohio have increased from 41 claims in 1990 to 391 claims in 2022, with the highest of 434 claims in 2019 and a total of 7,571 claims since 1990 (National Practitioner Data Bank [NPDB], 2023). In 1990, there were 4,693 claims against physicians, 6,350 claims in 2022, and 356,636 claims since 1990 (NPDB, 2023). APRN total adverse events from 1990 to 2022 is 59, the highest of eight claims in 2022 (NPDB, 2023). From 1990 to 2022, physician adverse events were 7,698, with the highest occurrence of 360 in 2011 (NPDB, 2023). In comparison, MD’s malpractice suits and events are decreasing, and APRN’s malpractice suits are increasing in Ohio as the number of practicing APRNs is increasing, and the number of physicians in practice is decreasing (NPDB, 2023). Medical negligence, also known as malpractice or medical errors, is an increasing public health concern among healthcare providers worldwide (Buppert, 2020; Dahlawi et al., 2021). It occurs when a healthcare professional selects the wrong method or procedure or improperly executes an appropriate method to treat or diagnose the patient, leading to a significant risk of patient disease, injury, disability, or death (Dahlawi et al., 2021). Medical suits and compensations can cost billions of dollars annually to the private and public healthcare systems, and loss of time, money, stress, and reputation of the provider (Dahlawi et al., 2021). This can create provider hesitancy in error disclosure and increase the cost of malpractice insurance, impacting the sustainability and success of a medical practice or hospital, thus reducing healthcare access (Mello et al., 2020).         
Buppert, C. (2020). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
Dahlawi, S., Menezes, R. G., Khan, M., Waris, A., Saifullah, .-., & Naseer, M. (2021). Medical negligence in healthcare organizations and its impact on patient safety and public health: A bibliometric study. F1000Research, 10, 174. https://doi.org/10.12688/f1000research.37448.1
Mello, M. M., Frakes, M. D., Blumenkranz, E., & Studdert, D. M. (2020). Malpractice liability and health care quality. JAMA, 323(4), 352. https://doi.org/10.1001/jama.2019.21411
National Practitioner Data Bank. (2023). Data analysis tool. U.S. Department of Health and Human Services. https://www.npdb.hrsa.gov/analysistool/
U.S. Bureau of Labor Statistics. (2022). Occupational employment and wage statistics. Division of Occupational Employment and Wage Statistics. https://www.bls.gov/oes/current/oes291171.htm

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