Last week’s conviction of a Nashville nurse for negligent homicide in the death of a patient could have a chilling effect on health care, according to local, state and national organizations.
On Friday a jury convicted RaDonda Vaught, who formerly worked at Vanderbilt University Medical Center, of reckless homicide and impaired adult abuse after she mistakenly administered the wrong medication to a 75-year-old female patient with brain damage in 2017, resulting in her death .
Vaught, 37, was acquitted on the charge of reckless homicide, which prosecutors were seeking.
Vaught administered Vecuronium, a strong paralytic, instead of Versed, a controlled substance which helps cause drowsiness and decrease anxiety.
NASHVILLE, Tenn. (AP) — A former Tennessee nurse is guilty of criminally negligent homicide in the death of a patient who was accidentally given the wrong medication, a jury found Friday. She was also found guilty of gross neglect of an impaired adult in a case that has fixed the attention of patient safety advocates and nurses’ organizations around the country.
The American Nurses Association and the Tennessee Nurses Association issued a joint statement about the verdict after the nurse self-reported the error.
“We are deeply distressed by this verdict and the harmful ramifications of criminalizing the honest reporting of mistakes,” according to the statement. “Health care delivery is highly complex. It is inevitable that mistakes will happen and systems will fail. It is completely unrealistic to think otherwise. The criminalization of medical errors is unnerving and this verdict sets into motion a dangerous precedent. There are more effective and just mechanisms to examine errors, establish system improvements and take corrective action. The non-intentional acts of individual nurses like RaDonda Vaught should not be criminalized to ensure patient safety.”
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Alan Levine, president and CEO of Ballad Health System, called the case tragic in a Saturday memo to Ballad employees but also noted the importance of reporting errors.
“Ballad Health has a culture of safety in which we encourage self-disclosure of mistakes without fear of penalty. This is critically important,” Levine wrote. “We need to know of any incident which could jeopardize patient safety, so we can make sure our systems are designed to minimize harm. Does this mean a nurse cannot be disciplined for negligent behavior? No. Our position has always been that we disclose medical mistakes, and we do not discipline nurses just because they made a mistake.”
The health system has guidelines in place for employees who don’t comply with nursing standards or system policies, Levine wrote.
Additionally, Ballad has safeguards and systems in place that appear to be superior to what Vanderbilt may have relied on in 2017, he added.
“When there is a medical mistake at Ballad, we do not abandon our nurses when they step forward to help us identify the cause of the mistake and work with us to help make sure the chance it can happen again is minimized. We have a zero harm policy. Each day, our safety huddles are designed to give nurses a voice in identifying patient safety issues so we can work together to resolve them,” Levine wrote.
In the wake of the verdict, Levine directed hospital CEOs and chief nursing officers to assemble focus groups with nurses in each Ballad hospital to get nursing staff input on the outcome of the case and if there are any other systemic opportunities to help ensure safety.
“It is a fact that there is a massive shortage of nurses nationally, and we are being impacted by it. It would be foolish of me to not acknowledge the impact this shortage has on the workflow of nurses and the potential impact on patient safety. It is a problem. And it would be irresponsible for health care policy makers and health system leaders to fail to acknowledge it,” Levine wrote.
“And in my opinion, it is unfair to hold a nurse to a criminal standard if the nurse did follow the policies and the practices of the employer responsible for the patient,” Levine wrote. “I cannot substitute my judgment for that of the jury and must respect the fact that there seems to now be a standard we need to pay attention to.”
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