The medical field is a vital part of life, the work is incredibly important no matter where you go. It’s thanks to our advanced medicine that the human lifespan has lengthened by decades. With the medical field being so broad there are some aspects that are overlooked by the average person. One of these things is medical hand offs. Today we will be discussing the importance of medical hand offs between departments, why proper tracking is important to an attorney, and how companies and hospitals can make sure the case is reviewed properly.

The Importance of Medical Hand offs between departments:

A medical hand off involves the transfer and acceptance of total care of to the receiving unit and assuming responsibility of that patient. This includes everything from medication administration, ordering medications, recording intake/output, vital signs, listening to the patient, follow-up on lab work and communicating abnormal levels to the physician and the next nurse taking over. Medical hand offs are very detailed oriented. For a patient hand off to go smoothly every single piece of information relating to the patients care needs to be relayed to those accepting the responsibility of the patient.

A successful hand off should include proper communication, verification, and documentation. Without these steps, something vital about patient care could be missed. Overtime, as the medical field has evolved, there have been many instances where patient care was compromised because of an improper hand off.

Though it may seem like an easy and routine thing, improper hand offs have resulted in several catastrophic problems for patients. Concrete statistics show that from 2011 to 2016, 1744 deaths were caused by improper hand offs, leading to roughly 1.7 billion dollars lost in malpractice lawsuits. What causes this?

Imagine this. You and your wife have just been in a severe boating accident. You are relatively okay, except for some cuts and bruises, but your wife is not so lucky. There are many complications of her care, including a hole in her respiratory system. Fortunately, everything seems to be going well. Your wife is making great progress along her recovery. There’s just one thing standing in the way of her going home. The final test will determine the next course of action on whether she will go home or stay in the hospital longer.

This is the case of Brent Nibarger’s wife, Jennifer. Her test went horribly wrong. She was diagnosed with a TEF (tracheoesophageal fistula), which is an abnormal birth defect. TEF’s are very rare in adults but are life-threatening complications which are caused from a blunt chest trauma. They are typically in young men who are involved in deceleration or crush injuries. With Jennifer being in a very bad boating accident it is possible that she had either undergone a crushing injury or blunt trauma.
The TEF was detected when Jennifer had to have one final exam to make sure she did not have any complications that were not seen before. She underwent a barium swallow test, which led to the diagnosis of TEF. The barium went to her lungs through the fistula versus going into her stomach, thus causing her to go into respiratory distress. She was not taken seriously as they treated her respiratory distress as anxiety.

As she was fighting for her life, she went between units and multiple care takers, while in respiratory distress it was finally concluded to place her on a ventilator after 36 hours. As the ventilator was pumping air into her system, it was not going into her lungs, rather it was going into her abdominal/stomach! Jennifer should have undergone surgery, but Jennifer suffered multi-system organ failure due to being oxygen deprived and went into a cardiac arrest for 14 minutes. Cardiac pulses were restored, however, she had oxygen deprivation to her brain. After, all the tests and consults, the conclusion was non-recoverable brain damage due to the lack of oxygen.

This happened because of multiple improper medical hand offs. Also, not listing to their patient. With all the information, it was a lack of attention to detail, thus the newly diagnosed TEF was not passed on in the hand off to those receiving Jennifer back from her exam.

How does medical hand off tracking matter to an attorney?

Medical hand offs are vital to patient care, and as such, they produce a paper trail. This paper trail can be used by an attorney to follow the case.

The paper trail tells the story of the client’s incident. Legal nurse consultants understand this process as they have to hand off their patients to the oncoming staff, communicating with the physician or other staff that are taking care of them, not to exclude transportation personal to exams, or lab technicians, and dietary. Let’s put it this way, anyone who comes into contact with a patient and has a role in their care should know what is going on with the patient, to insure proper care.

The paper trail can tell us a lot of things. It can tell us who, what and where that patient has been and had done to them during their stent in the facility. Important fact about keeping diligent records and charting, informs where the hand off either was successful or failed. But, more importantly, where did it all go wrong? What caused the death at hand?

In Jennifer Nibarger’s case, the paper trail can tell us that there weren’t any precautions taken for the newly found fistula in her respiratory system. It’s uncertain to if the staff running the test even knew about it, so, how could they?

Such a paper trail also works to establish liability. The question “who is responsible for her death” can be answered by legal nurse consultants assisting with reviewing the medical record. Without them, it would be logical to assume that those who ran the test are at fault, but her medical records can show that they weren’t properly informed, placing liability on the improper hand off and whoever executed it.

How do the companies and hospitals play a role in medical hand offs?

Jenifer Nibarger’s case is extremely tragic, mainly because it was preventable. So, how do we make sure a death like hers doesn’t happen again?

As human beings we are flawed. We all make mistakes at our jobs. When medical professionals make mistakes, people can die. This is the big reason that initiating a proper medical hand off shouldn’t just be up to the individual. Corporations and hospitals that facilitate care have a role huge role to play!

Important fact that all companies should enforce, proper training and education for medical hand offs. The three main steps to a proper medical hand off are

Proper communication is vital to making sure a patient’s needs are met. Verifying that each point of a patient’s case has been brought to attention to each caretaker, which is vitally important to make sure the patient has not adverse events. Finally, documentation that creates an easy record of the patient’s care, extremely essential.

It’s up to companies to ensure that these points are enforced and are working to keep patients safe. Another thing that a company is responsible for is making sure that it’s an easy and understandable process for the medical staff.

If walking through a medical hand off is like trying to get through a maze, then something needs to be fixed. Having a set routine and making sure everyone is informed with the proper way medical hand offs should work, can help elevate the tragic results. It is important to stay up to date and make changes when life altering events happen.

Medical hand offs are vital to patient care and must be treated with respect and attention to detail to make sure that each patient receives the highest quality of care.

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Legal Nurse Consultants can help attorneys work through the maze and determine if proper medical hand offs were completed and if information/data was not passed on. Sad story that should never have happened. Legal Nurse Consultants are essential assets to your case.