What are the legal implications of care pathways?

April 10, 2009 by admin 

What are the legal implications of care pathways, increasingly used by nurse prescribers to manage sometimes complex chronic conditions? Could they be used as legal swords for patients seeking compensation, or will they provide shields for nurse prescribers, by providing courts with evidence that the interventions were evidence-based best practice? The latter, is the reassuring conclusion of this article. Richard Griffith, a lecturer in health law, looks at whether care pathways make nurse prescribers more liable to face litigation. He explains how the Bolam test works in practice: if the actions of a nurse prescriber accord with practice accepted by a respected body of professional opinion, the standard of care will not have been breached. However, this standard of care must stand up to logical analysis and a nurse prescriber “will not be exonerated because others are negligent or common professional practice is slack”. He argues that is unlikely that care pathways will promote litigation, given their purpose and evidence-based nature. They are likely to be considered by a court as another form of evidence of practice, not as inflexible rules of conduct: deviation from them will not be automatically assumed to be negligent but is likely to be subject to the test of whether it is a logical, evidence-based response to patient needs. Nor, however, will blindly following a care pathway protect a prescriber from successful negligence suits. The author advises that if a nurse prescriber deviates from a care pathway, this should be well documented and reviewed. Care pathways, properly considered and evidence-based, will therefore act as shield to protect nurse prescribers.

Griffith R. Nurse prescribers, care pathways and the law. Nurse Prescribing 2008; 6(10): 456-459.

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