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Posted on April 20th, 2012, by

Today, the quality of health care services is of the utmost importance because the technological and scientific progress provides health care professionals with ample opportunities to treat patients effectively, save their life and health in cases of the most serious diseases. However, the provision of health care services of the high quality is still not always possible. In this respect, it is necessary to mention two major reasons of the inadequate health care assistance or treatment of patients. On the one hand, the quality of health care services is question of the availability of health care services to patients, since many patients, especially uninsured ones, do not have access to health care service of the high quality. On the other hand, the quality of health care services is the problem of the inadequate work of health care professionals who provide substandard health care services for patients that produce a negative impact on the health and, what is more, can lead to lethal outcomes. The latter problem is particularly significant since patients should receive health care services of the high quality and the professional level of health care specialists should be adequate to their position in order to avoid possible negative effects on the patient’s health because of professional negligence or substandard patient care. In this respect, it is possible to refer to the case of Convalescent Services Inc. vs. Schultz (Court of Appeals of Texas, 1996), which revealed the negative impact of substandard patient care on the patient’s health.

On analyzing the case, it should be said that the patient was transferred to a nursing home after an acute-care hospital admission for pneumonia. The patient was seventy-seven years old when he was transferred to a nursing home. Moreover, he was afflicted with advanced Alzheimer’s dementia. The state of the patient was quite serious because he was bedridden, incontinent and his limbs were contracted. On admission to the nursing home, the nursing staff who assessed him noted he had a large, very dark red area on his coccyx and buttocks, which was classified as Stage I or II decubitus ulcer (Davis et al., 2006). The ulcer worsened to at least Stage III when the skin surface broke open eleven days after admission to the nursing home. Furthermore, five weeks later, the patient was hospitalized for aggressive treatment of the steadily deteriorating ulcer, which had not only increased in size, but also had progressed to the Stage IV, exposing the bone (Davis et al., 2006). After that the patient underwent several surgical procedures, including the debridement of the dead tissue and placement of a surgical flap to cover the exposed bone. In the result of the three-month hospitalization, prolonged by post-surgical infections, the patient was released and re-admitted to the nursing home (Davis et al., 2006).

However, the family filed suit against the nursing for negligence and gross negligence. The family claimed that the nursing care in the nursing home was so substandard that it precipitated the deterioration of the ulcer and that this deterioration and the resulting surgical intervention were preventable if proper nursing care had been giver to the patient (Spiegel et al., 2003). The trial resulted in a substantial jury verdict against the nursing home for compensatory damages for negligence and punitive damages for gross negligence (Spiegel et al., 2003). The nursing home admitted the responsibility for payment of the compensatory damages which the jury had awarded and paid those damages to the family, but filed an appeal to contest responsibility for payment of the punitive damages.

Eventually, the court ruled that the nursing home was guilty of gross negligence for the substandard care of this patient and should pay the punitive damages (Spiegel et al., 2003).

In such a way, the nursing home was punished for the substandard patient care. Although, it is worth mentioning the fact that the position of the nursing home was weak because the patient did not receive the treatment he needed to avoid the further deterioration of his health. To put it more precisely, taking into consideration his health problem, the nurses should follow the protocol of careful bathing, they should turn and reposition the patient frequently, use a special mattress if ordered by the physician and ensure that the patient’s nutritional needs are met. In such a way, the nurses should follow the strict order of the treatment of the patient and provide him with basic but essential care which could prevent the development of ulcer and the further surgical intervention and the health problems that followed it.

In such a context, the problem of the quality of health care services becomes particularly significant because the patient practically became a victim of substandard patient care services. In fact, what the nurses needed to do simply to follow the established, standard procedures which are normally applied in the treatment of patients which have similar problems as the patient in the aforementioned case. However, the nurses proved unable to provide the standard health care services that led to the deterioration of the patient’s health and surgery.

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