Avoiding a Breach of Duty: Nursing and Healthcare Facility Tips

When healthcare providers care for patients, they’re expected to adhere to all professional guidelines to deliver the best services possible. But sometimes, the care they deliver can fall below expected standards and lead to patient harm — either incidentally or, in rarer cases, because of malicious intent. This is more formally known as a breach of duty.

Nursing staff, physicians, and other healthcare professionals must ensure that the care they provide aligns with industry standards to prevent adverse incidents and potential legal repercussions. In this article, we’ll explain what breach of duty means and provide five actionable tips to keep your team practicing safely.

What Is a Breach of Duty? Nursing and Healthcare Staff Overview

To better understand what breach of duty of care means, it’s helpful to differentiate the following two concepts: “duty of care” and “breach of duty.” Duty of care refers to the legal obligation that an individual has to avoid careless acts that can harm others. Breach of duty is a form of negligence that occurs when someone breaks this obligation — failing to meet expected standards of care.

In a very broad sense, healthcare providers are obligated to do no harm to their patients. This is their broad duty of care, although more specific duties can apply based on a provider’s specific clinical practice area and related standards of care. When they fail to follow appropriate protocols or commit careless acts that cause injury, they can be found to have committed a breach of their duties. Common breaches of duty can include:

• Misdiagnosis
• Improper treatment
• Wrong medications
• Premature discharge
• Failure to diagnose
• Misreading of lab results

Breach of Duty of Care: Examples

There are many situations that can lead to a breach of duty, and this can occur either intentionally or unintentionally. To help you better understand how a provider breaches a duty of care to a patient, we’ll outline two physician and nursing breach of duty of care example scenarios below.

Example 1: Intentional Breach of Duty (Physician Example)

A patient visits the ER because they’re experiencing abdominal pain. The doctor doesn’t conduct a routine assessment, and instead brushes the patient off as having food poisoning because they’re wrapping up their shift. The patient is later readmitted to the hospital because their pain was actually caused by appendicitis. Since the appendicitis was not treated early enough, the damage caused by breach of duty of care includes significant suffering and long-term negative impacts to the patient’s health.

What was the breach of duty of care? Negligence or malpractice in this scenario was based on the physician failing to properly work-up and diagnose a patient’s health condition when it was necessary to do so.

Example 2: Unintentional Breach of Duty (Nursing Example)

A nurse is intaking a patient on a particularly busy work day. Because she is being rushed to see other patients, she mistakenly leaves fields blank on the patient’s medical chart. This causes the team to overlook a penicillin allergy. They end up administering it to the patient, which then causes a life-threatening, anaphylactic reaction.

What was the breach of duty of care? Negligence or malpractice in this scenario was failing to appropriately document a patient’s allergies and subsequently administering a contraindicated medication. It might also extend to management based on inadequate staffing issues.

Breach of Duty of Care in Healthcare: Legal Consequences

If a patient is harmed due to suspected physician or nursing negligence, this can lead to a malpractice lawsuit, and involved facilities may need to undergo an investigation. A breach of duty in tort law holds providers responsible for compensating patients for any psychological, financial, and physical damages that they endured because of their wrongdoing.

Depending on the harm involved and the actions leading up to a breach of duty, nursing staff, healthcare providers, and the facility they work for also could face criminal investigations and charges.

5 Tips to Prevent Breach of Duty at Your Facility

Now that we’ve gone over what a breach of duty is and what it can look like, you may be wondering how to prevent it at your facility. Here are five tips to help you maintain regulatory compliance and ensure your staff are meeting expected standards.

1. Implement Evidence-Based Policies and Protocols

As a facility leader, it’s important to implement and enforce clear protocols that reflect the highest standards of care. Staff should have continuous access to these policies so that they can incorporate best evidence-based practices into their daily work. Professional resources that can help you build stronger care protocols for your facility include:

• The U.S. Task Force’s recommended clinical guidelines.
• GRADE system for vetting and incorporating clinical evidence.
• The Agency for Healthcare Research and Quality’s clinical decision support tools.

2. Support Continuous Education (CE) and Training

The healthcare landscape is constantly changing. If your clinicians are following outdated practices, this may lead to an unintentional breach of duty. Nursing staff and other healthcare employees can complete continuing education courses to stay up-to-date on the latest industry standards. Here are three ways to support continuous education at your facility:

• Offer CE credits and encourage staff to complete professional development courses.
• Conduct thorough training when implementing new technologies or policies.
• Provide hands-on workshops or seminars that teach staff new clinical skills.

3. Maintain Safe and Appropriate Staffing Levels

Inadequate staffing and poor supervision are both common contributors to medical errors. Therefore, maintaining adequate staffing levels is necessary to help your staff avoid an unintentional breach of duty.

Nursing staff, physicians, and other support teams need enough time, resources and manpower to ensure that no essential steps in the care process are overlooked. To enhance your staffing strategy, you can:

• Work with a staffing partner that can help you stabilize your workforce.
• Utilize temporary or float nurses to fill vacancies during peak periods.
• Hire more ancillary staff (e.g., medication aides) to ease the workload of nurses.

4. Foster Clear Channels of Communication

Miscommunication is also a key contributor to preventable medical errors. As a facility leader, fostering effective communication among your staff is an important way to enhance teamwork and strengthen care coordination so that no pertinent information is missed. You can foster better communication among your team by:

• Using technology, such as electronic health records, to streamline information exchange.
• Standardizing patient hand-offs using tools such as I-PASS.
• Conducting regular team safety huddles.

5. Maintain an Effective Incident Reporting System

Even if your team is doing its best to prevent a breach of duty, missteps can still happen. This is why an incident reporting system is an essential part of any healthcare facility. An effective reporting system can help you identify, address, and learn from mistakes, which can also help prevent similar issues from occurring again. Here are three ways to ensure you’re getting the most out of your reporting system:

• Implement an easy-to-use, electronic reporting system that staff can easily access.
• Analyze and respond to reports in a timely manner so that no information goes to waste.
• Promote a non-punitive reporting system so that staff are encouraged to file reports.

Is Your Facility Meeting the Highest Standards of Care?

In order to prevent a breach of duty, nursing staff and other healthcare clinicians require support, guidance, and resources. Want to help your team stay informed? IntelyCare’s clinical experts have developed hundreds of healthcare tips and insights to help you deliver the best care possible.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.