Teleseminar Transcripts Package - Spring 2009

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Sharpen your skills in a convenient way by reading the transcripts of the Spring 2009 teleseminars. You’ll receive over 100 pages of transcripts in a convenient downloadable PDF file. Our seven experts will inform you, hone your knowledge, and let you in on some surprising information that will strengthen your skills.

Some of the highlights of each program are listed below.

Medical Malpractice Topics

After the Fall
by Barbara Levin BSN LNCC ONC

How do you define a fall?
Is an assisted fall really a fall?
How many falls occur each year?
How much money does the Centers for Medicare and Medicaid pay out each year because of falls?
What are some of the ways that a nurse could identify somebody who is at risk for falls?
Is there one standard falls risk assessment that facilities should be working towards implementing?
When you have got a high risk population on a nursing unit, what are some of the strategies useful for reducing the risk of falls?
What are the benefits of hourly rounds?
Why do older people tend to have poor outcomes after a fall has occurred?
What are the financial consequences for falls that occur in hospital settings?
How does documentation affect the analysis of liability after a fall occurs?
What are facilities doing to modify the environment to make it safer?
What is the role of a sitter?
What are the common types of fractures?
How does the type of fall affect the fracture that results?
Is there any outside window that the surgeon can wait before it becomes too late to attempt a surgical closure of a fractured hip?
How are closed reductions performed?
What are some of the postoperative risks following surgery for fractures? Aren’t these “never events”?
Could you comment about some of the controversies regarding surgical site infections?
Could you comment about pressure sores developing in people who've had surgery to repair a fracture?
Are you seeing less use of Foley catheters in patients after they have had hip fractures repaired?
One third of patients who suffer a serious fracture die within a year. Why?

Death by IV Catheter: Air Embolism and IV Catheter Related
Sepsis
by Susan Masoorli RN

How long have air embolism issues been of concern?
What are air emboli?
Can they be detected by diagnostic testing?
What are some key ways in which air can get into the system?
How do those mechanisms relate to the standard of care?
Why do manufacturers offer Luer slip devices if these are more dangerous?
How do holes get into IV tubing?
What precautions should be followed when a central catheter is removed from the vein?
What is an occlusive dressing?
What should the patient be instructed to do during central catheter removal?
What emergency equipment should be at the bedside when a patient has a central catheter in place?
What are nurses expected to do if a confused patient is trying to pull out lines?
What are the symptoms of an air embolism?
How quickly can a patient die of an air embolism?
Is there any way to get the air out?
In the cases that you’ve been involved in as an expert, what has been the outcome for the patients who have gotten air in their system?
What types of catheters are considered high risk for air emboli?
What factors have to be present for an air embolism to occur?
What are the key legal issues that seem to come up in establishing the negligence or the defense aspects of a particular air embolism case?
Are air embolism cases difficult for the plaintiff to win?
How common and costly are air embolism cases?
What is the impact on the patient of getting sepsis from an IV catheter?
Is it difficult to establish liability with a catheter related infection?
What key step in IV catheter insertion is not commonly employed?
What does “stop the line” mean?
How costly are IV catheter related infections?
Are there ways to increase compliance with hand washing?
What is an easier aspect of liability to prove related to IV catheter sepsis?
What are some classic symptoms that would be seen in somebody who is developing sepsis from an IV catheter?
Which two groups of patients are at high risk for problems caused by removal of PICC lines?
Which two central catheter insertion sites have the highest risk of infection?
What are your recommendations for avoiding IV catheter-related sepsis?
From the liability perspective, if an attorney has a case involving an IV catheter line, what suggestions would you provide to the attorney who is trying to determine if there is indeed liability associated with that catheter-related sepsis?

Death in Seclusion or Restraints
by Wanda K. Mohr PhD APRN FAAN

How many people die in seclusion or restraints each year?
Is there an impact on patients who watch another patient being restrained?
What are a few myths associated with restraints?
What are the conditions that cause people to die while in restraints?
How are you defining restraints- a product sold from a catalog or the act of preventing someone from hurting themselves or others?
What does the term “seclusion” mean?
What keeps a patient within a seclusion room?
What types of places within healthcare use the types of restraints that we have been discussing?
How often are leather restraints used at this time?
What entities regulate the use of restraints?
What type of training should be available for staff using restraints?
What group of healthcare providers typically does not get trained on using restraints?
Why would restraints be used in a public school?
What are the alternatives that are available to the staff when a patient needs to be restrained?
Do staff behaviors come into play in some of the injuries that you have seen in dealing with restraints?
What is a common staff behavior that affects the outcome of restraining a patient?
What would the ideal milieu look like to structure the environment or the interactions in such a way that the escalation wouldn’t occur?
What are the financial costs associated with a restraint episode?
How does the psychiatric illness of the patient affect the ability of the judge, jury or arbitrator to identify with the patient?
What are the psychological, sequelae or effects of being restrained or observing somebody who is being tied down or brought down to the floor?

IV Therapy: Complication or Malpractice?
by Susan Masoorli RN

What is the difference between infiltration and extravasation?
Which medications are particularly caustic if they leak into the tissues?
Is an extravasation an accepted risk of IV therapy?
What is the proper method for assessing a peripheral IV device?
Is there a definition of frequent monitoring of the IV site?
How does the nursing shortage with the fewer numbers of registered nurses and the increased number of nursing assistants affect monitoring of IV sites?
What is the aftercare for infiltrations and extravasations?
Why should heat never be applied to an extravasation?
What kind of documentation is needed when an infiltration or extravasation occurs?
Why are neonates and the elderly at particularly high risk for extravasation?
Where would an expert witness, healthcare provider or attorney look for standards of care for IV therapy and vascular access devices?
What are the most critical clinical and legal issues related to infiltration and extravasation?
What negative outcomes are associated with infiltration and extravasation malpractice cases?
What kind of permanent damages do they cause?
What documents should be requested as a part of discovery for infiltration and extravasation malpractice cases?
Is an infiltration an indication that a departure from the standards of care occurred?
Is an extravasation an indication that a departure from the standards of care occurred?
What safety precautions should be used to protect a patient from a fall-related injury during or after a venipuncture?
Is nerve injury related to venipuncture a common area of malpractice?
Is there a typical symptom a person experiences when a nerve injury has occurred?
What does the person performing a venipuncture need to know to safely perform the procedure?
What two areas of the hand should always be avoided when an IV is started?
What is the primary risk of starting an IV in the inner elbow?
Why should the femoral area be avoided for IV access?
What is the primary risk of starting an IV in the jugular artery by mistake?
What is the first thing a person should do if there is a sign of a nerve injury during an attempt to insert a needle into a vein?
Is there any technology that permits visualization of the vein?
What information do you look for in the medical record to diagnose nerve injury?
Why are nerve injury cases often difficult for the plaintiff to win?
Are there any effective treatments for patients who have had nerve injuries?
A piece of IV catheter tubing can break off and travel to the heart. How does that happen?
What should a healthcare provider do when she or he realizes the plastic has disappeared?
Can you retrieve the plastic? What damages can it cause?

Business Topics

New Technology to Grow Your Business
by Victoria Powell RN CCM LNCC CNLCP MSCC CEAS II

What is the most essential technology today for somebody who wants to improve efficiency and be connected?
What is a power inverter?
What is a Netbook?
As you think about all the aspects of technology that are available to us, what do you think are the areas that are underutilized at this point?
How can social media be used for business activities?
How can Twitter be effectively used?
How should you use the groups on LinkedIn?
How do Facebook and LinkedIn differ?
What is a blog carnival?
On what social media sites are predators lurking?
If you establish a profile several social media sites, is there any way to update all those sites simultaneously?
How can you effectively use email?
How can you increase the number of visitors who come to the website?
Do you have any suggestions for blogging?
How can you repurpose blog posts?
What does Web 2.0 mean?
Why would you want to have Google alerts?
How do you manage to find the time or improve your efficiency by connecting all this and still have a life?

Refocusing Your Business in Tough Times
by Patricia Bemis RN CEM

What is the one-stop shop and how does that applies to being in business?
How does “stick to the knitting” apply to doing business differently and trying new things?
What formula do you use for pricing services?
What strategies can be used by business people to cope with the changing economy?
What suggestions can you offer on focusing on personal relationships or business relationships with our client base?
Do you see changes in terms of how people are interested in being treated or connected with?
What is the biggest point to remember when using email?
How can we build relationships through email?
What is the best way to preserve a relationship with an unhappy client?
What suggestions do you have for building relationships through the websites?
What suggestions do you have for using technology to refocus your business?
How do you use ACT! and logmein.com to improve your efficiency?
How can a virtual assistant be effectively used by a small business?
What are your thoughts on the utility of blogging?
What is a squeeze page on a website and how do you use it?
How can a mastermind group help a business owner?
How can surveys be used to improve one’s performance?
Can you comment at all about using surveys and interacting with clients?
How can you use champion customers to sustain your business?

Legal Topics

Show, Not Tell
by Stephen Appelbaum CEP EPIC

Where and when do we begin collecting or preserving demonstrative evidence?
What are advantages and disadvantages of taking photographs with cell phones?
What is a potential source of pictures of a car involved in a car crash?
What are some essential questions to ask before planning any type of demonstrative evidence preparation?
What is the most important question to ask?
What is a before and after exhibit?
What is an anchor exhibit?
How can a timeline be used effectively?
What are some essential principles that should be considered when developing a timeline?
What color combination offers the most contrast?
Why is it important to do a timeline to scale?
Are there certain associations that we have with colors, and should those associations be considered in selecting colors for various parts of an exhibit?
What are some general principles that should be considered when putting together exhibits that include medical illustrations such as anatomy or surgical storyboards?
How do we know before we go into the courtroom that they are actually going to accomplish the purpose that we intend?
Why should the attorney generally avoid having pictures taken of the patient in the hospital after an injury?
What are the advantages and disadvantages of the high tech approach in the courtroom?