Explore the principles and practices of legal nurse consulting that will help you get started in the profession. Experienced LNCs will discuss lawsuit processes, research, practice areas, medical record review and business principles.

Discover what you need to know to obtain the LNCC credential. This is an advanced, high level overview of key content and topic areas on the LNCC certification exam. It is designed to help participants prepare for the exam and identify those areas in which further study may be necessary. Seminar content is based on the exam blueprint and taught by LNCCs with content-specific experience. Test taking tips and practice questions developed by the American Legal Nurse Consultant Certification Board (ALNCCB) also will be included.

Moving from bedside to board room can be a scary experience for nurses. Making mistakes in start-up or operations can cost the LNC cases and perhaps slam the door on future business. This session will discuss the principles of business start-up, provide resources for ongoing business management and help the LNC avoid some common pitfalls in business growth. Attendees will leave with tools to evaluate their entrepreneurial abilities and resources for building a customer base.

This lively presentation will focus on the ins and outs of contracting and subcontracting. Results of a nationwide survey will be shared answering questions about LNC roles, including compensation. The first hour of this session will dive into legal nurse consulting by exploring the role of a subcontractor. It will review the essential tools, including subcontractor pre-requisites, business principles and ethics. Vital characteristics for compatibliity with contractors, successful contract negotiation and ethical considerations will be covered. Specific marketing strategies are also included in this subcontracting tool box. The second hour will focus on hiring a subcontractor and discussion will focus on how to find the right subcontractor, management of multiple subcontractors and exploration of ethical considerations.

By 2030, 64.5 million Americans will be over 65 years of age and 8.5 million will be over 85 years of age. Currently, more than 25% of all trauma admissions involve an elderly individual. For many years, no real trauma protocols existed for elderly trauma care to provide optimal outcomes. This presentation will highlight the multiple factors affecting geriatric trauma outcomes, including physiological changes, treatment and triage decisions and common mechanisms and injury patterns. Additionally, various studies will be discussed focusing on several geriatric trauma patients and their less-than-optimal return to a previous level of independence. The speakers will define the "elderly" and discuss the role that normal physiological aging responses to trauma have on the elderly injured patient.

Experienced attorneys, non-electrophysiologists, consultants and reviewers of medical-legal matters have difficult interpreting, comprehending and evaluating medical records and issues related to the complexities of pacemakers/ICDs and potential litigation. As with any specialty, cardiac rhythm management device therapy has its own language, acronyms and variables related to legal consulting. This session will discuss a systematic approach by reviewing several case examples from multiple manufacturers to assess proper function. Also, it will analyze device-related issues to determine clinical error vs. device malfunction.

Have you ever been locked in a glass coffin? Completely paralyzed? Able to see, hear and feel everything but completely unable to tell anyone that you were alive? Who was there to defend you - not just treat you, but defend your right to the best treatment possible - to defend your right to live?
The double pontine stroke that thrust Kate Adamson into total paralysis ("Locked-in Syndrome") forced her husband Steven into the role of patient advocate. As the patient's husband and attorney, Steven had to deal with the legal, personal, spiritual, moral and medical ramifications of his wife's "journey" through the dark tunnel of total paralysis, overcoming one-in-a-million odds against survival to emerge into the light of her new life.
This session is a deeply inspirational reminder of why medical and legal professionals initially entered their professions and how powerful combining those professions can be. Once considered "dead" - her life not worth saving - Kate Adamson now travels the country as the only professional speaker to have recovered from Locked-in Syndrome. Kate doesn't just understand what you do; she is why you do what you do. Without the legal and medical experts that saved her, she would be warehoused in a long-term care facility - or dead.

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Part 1 of 2: A well-known and respected plaintiff attorney who has won many multi-million dollar verdicts in the arena of Long Term Care (LTC) and elder abuse cases will go head-to-head with a defense attorney who represents a number of nationally recognized long-term care providers and physician groups. With Hon. Person moderating, the panel will review regulatory history and complaint investigation, corporate ratification, staffing issues, neglect and recklessness, causation and tips for depositions and trials to help the right side win the case. This is an audience participatory program with on-the-fly discussions welcome. The panel will discuss recent developments in long-term care law and identify fundamental LTC litigation skills.

INA, CCM, LNCC

This session focuses on case law concerning pressure ulcer and the documentation of nurses and healthcare facilities. It also presents an oversight to the pathophysiology of wounds and gives the LNC an insight to what documentation and information is important when reviewing the medical record. Key elements needed to properly document pressure ulcers will be discussed, as well as an analysis of the different tools used for the documentation of pressure ulcers.

INA, CCM, LNCC

The Centers for Disease Control and Prevention (CDC) reports that almost 1.5 million people in the United States sustain a traumatic brain injury (TBI) each year. Of those, 50,000 die, approximately 250,000 are hospitalized and 1.1 million seek treatment in emergency rooms. It is unknown how many individuals seek alternative medical care or no care at all following head trauma. In addition, it is estimated that someone suffers a TBI every 15 seconds in the United States, either as a result of a fall, motor vehicle accident, assault, gunshot wound or some other direct blow to the head. Many brain injured individuals seek legal representation as the impact on their lives becomes more and more prominent in their activities of daily living. The legal nurse consultant is an integral part of the legal team, especially in dealing with clients with traumatic brain injury. More importantly, the legal nurse consultant, as a result of his or her education and experience, becomes an essential member of the litigation team assisting the attorneys in representing clients with TBIs. This presentation will provide a general overview of traumatic brain injuries and the role of the LNC involved in these types of cases. It will cover the signs and symptoms of TBI, diagnostic and neuropsychological testing, and finally, the impact a TBI has on the medical, cognitive and social components of an individual's life with a traumatic brain injury: the good, the bad, and yes, even the ugly.

INA, CCM, LNCC

Taking the sights, sounds and people of your case to the audience allows you to expand their understanding of the evidence and enhance the ultimate outcome of the case. This multimedia presentation will demonstrate exactly how to dramatize any case for trial or mediation using easily accessible technology. It will cover exactly how to outline, build and present a multimedia work at mediation. Through the use of video, audio clips and still pictures from actual cases, attendees will learn what works and what doesn't in building a winning presentation. Handouts outlining the basic technology and software necessary to build and present a multimedia project will be provided, as well as references to helpful Web sites, publications and authoritative sources. The expectation is that the audience will see a presentation not unlike that depicted in Al Gore's movie, An Inconvenient Truth, combining animated POWERPoint to enhance the speaker's message.

INA, CCM

This session will provide an overview of the Good Clinical Practice (GCP), federal and state regulations that guide the conduct of clinical research trials involving drugs and devices in human research subjects and will include an in-depth discussion of the various parties involved in the clinical research implementation process. The session presentation also will include case reviews, references and resources for the attendee, as well as a list of federal regulations and agencies that guide the conduct of clinical research in the United States.

INA, CCM, LNCC

Part 2 of 2: A well-known and respected plaintiff attorney who has won many multi-million dollar verdicts in the arena of Long Term Care (LTC) and elder abuse cases will go head-to-head with a defense attorney who represents a number of nationally recognized long-term care providers and physician groups. With Hon. Person moderating, the panel will review regulatory history and complaint investigation, corporate ratification, staffing issues, neglect and recklessness, causation and tips for depositions and trials to help the right side win the case. This is an audience participatory program with on-the-fly discussions welcome. The panel will discuss recent developments in long-term care law and identify fundamental LTC litigation skills. Part 2 will teach attendees how to apply strategies in preparing a LTC case and testimony. Also, it will define the differences between elder abuse, neglect and recklessness.

INA, CCM, LNCC

Gain an introduction into the world of hospital billing. Emphasis will be placed on recognizing and interpreting data on the itemized bill and UB04 hospital claim billing form. A comprehensive review of ICD9 and CPT coding will be addressed as it applies to billing. Current topics related to Medicare and private insurance billing (i.e., "never events") and other issues will be discussed. At the conclusion of this presentation the legal nurse consultant will recognize the impact that analyzing the patient's billing will have on the overall case workup and value the attorney.

INA, CCM, LNCC

Understand what defines "assisted living" and identify those that are considered part of its population. Attendees will discover what ALF stands for, the standard of care for ALFs and the liability issues associated with ALFs. Also, learn how to defend/prove the breach in standards of care for ALFs.

INA, CCM, LNCC

Learn how to use the nursing process in writing life care plans by including the North American Nursing Diagnosis Association (NANDA)- approved nursing diagnosis to assess, diagnose and prescribe care for catastrophically injured patients. The session also will offer a review of how the nursing process applies to life care plan development and evaluate life care planning documentation from a legal perspective.

INA, CCM, LNCC

This interactive presentation will address how new clinical practice guidelines and government regulations (including the Present on Admission Regulation for acute care and Federal Tag 314 for long-term care) are affecting liability cases for wound care. The panel of experienced wound care nurses (who also prepare legal chart reviews and act as expert witnesses) will address hot topics such as: timely and appropriate wound assessment and referrals, underlying etiology issues, use of clinical practice guidelines and the deteriorating wound. Non-healable wounds, wound-related symptom managment and an ulcer liability case will also be covered.

INA, CCM, LNCC

The travel and agency nurse has been employed in the healthcare system to supplement regular staff members. There have been a number of studies related to patient outcomes and the travel nurse. This session will open with an overview of patient safety studies. Through the use of actual case studies, obstacles to safe practice will be identified and discussed. Malpractice also will be explored using complaints, medical records and deposition testimony. Measures to promote safe practice will be discussed using actual policies developed and excerpts of interviews with nurse managers, risk managers, attorneys and travel nurses.

INA, CCM, LNCC

This presentation will provide basic information on underreporting, myths versus reality, and interview techniques the first responder and medical personnel should consider when talking with this population about sexual assault. The medical findings, or lack thereof, will be presented with specific cases to illustrate the history and the findings of the forensic evidentiary examination. Consideration regarding modification of equipment that might be needed to perform the examination also will be highlighted, as well as information on service barriers or gaps that contribute to the exclusion of individuals with disabilities from participation in medical and social services specific to healthcare.

INA, CCM, LNCC

Jury bias has long been the subject of controversy among judges, legal scholars and trial lawyers. Eliminating juror bias is indispensable to a fair trial. This session will present The Jury Bias Model tool, now being used for more than a decade. With 28 years of study on juror judgement and decision making, the presenter will discuss how jurors make decisions unconsciously and how to frame the medicine for the best change of winning. See how the LNC can benefit the attorney during the jury selection process and how jury bias has a direct influence on your case. Learn to identify three factors that contribute to jury bias and three factors that must be considered of every jury member in the selection process.

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Ethanol, at a level of 0.25 grams, produces amnesia while one can still be behaviorally intact. Date rape drugs (benzodiazepines, GHB, etc.) add to this effect. Thus, a "victim" who does not remember sexual activity claims rape and the partner is charged with having sex with an unwilling and unconscious victim. The defendant has no means of assessing the "victim's" ability to form memory and claims the victim was awake and an active participant in sexual activity. Who is the jury to believe? Pharmacology explains what happened by delineating the biological mechanisms that result in formation of memories, how this is affected by sedative drugs and how this is clearly differentiated by behavioral actions. One simple example involves Versed for a colonoscopy procedure: the patient is fully awake, but amnesic. This session will describe the biology of memory formation as production of new "memory proteins" from DNA within glutamate neurons. It also will illustrate how blockade of memory formation is clearly differentiated from one's ability to act, behave, or participate in behaviors such as sexual activity.

This session will review the laws and standards surrounding the concept of e-discovery. The review will discuss all laws and regulations pertinent to discovery of electronic documentation of varying forms. Electronic medical records, instant messaging, e-mail, Blackberry and cell phone communications, e-prescription, fax and others will be reviewed. This review will look at two aspects of e-discovery: from the side of the legal team attempting to access the documentation as well as from the perspective of the reviewing facility with organizational procedures to limit liability. Other items that will be discussed include equipment and the formats and programs used by coporations and legal teams for maintaining and sharing the electronic documentation.

An individual's right to refuse or remove life-sustaining treatments is well established by federal and state laws. Under the fundamental right of self-determination, advanced directives enable competent individuals to give medical instructions or appoint an agent to make healthcare decisions should the individual become incompetent. Even with state immunity statutes for healthcare providers for withdrawing or not implementing life-sustaining treatments in accordance with an advanced directive, lawsuits and research studies demonstrate that healthcare providers often don't implement a patient's advanced directives. Reasons postulated for nonimplementation of advanced directives will be discussed with specific cases cited. Relevant guidelines for healthcare providers to implement to reduce potential liablity when dealing with end-of-life care issues will be discussed. In addition, guidelines for use by an LNC when evaluating a medical record and associated documents for a case alleging damages caused by a healthcare provider's failure to implement a patient's advanced directive will be explained.

This is your opportunity to ask members of the American Legal Nurse Consultant Certification Board (ALNCCB) any questions you may have regarding the LNCC exam or recertification process. ALNCCB members will also present the history of the LNCC® exam.

Gain insight into the legal nurse consultant's role in maximizing damages from an attorney's perspective. Discussion points will include how to help an attorney maximize the damages of an CRPS/RSD client and how to emphasize the best qualities of the client and the case.

INA, CCM, LNCC

The presenter of this session has worked for two years as the legal nurse consultant for the defense of homicide against parents accused of committing shaken baby syndrome. In every case the client was successfuly defended against the charges when it was determined medical malpractice was the real cause of the child's death. This session will review the complexities involved when working on such a case and the modalities of injury generally faced in this type of situation. An actual case will be referenced throughout the presentation.

INA, CCM, LNCC

Learn about the remote historical background of Chronic Traumatic Encephalopathy (CTE) in sports in the United States and how Footballer's Dementia was discovered in 2002 in American football players. The clinical profile, symptoms, signs and manifestations of CTE in American athletes, especially in retired football players, will be presented. The requirements for definitive forensic diagnoses of CTE will be discussed as well as the emerging common features of CTE in the football players and wrestler examined. The emerging socio-cultural and medico-legal issues surrounding CTE in professional and non-professional athletes also will be covered.

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This presentation is based on an article published in Circulation in July 2007 written by the lead cardiologist from St. Francis Heart Center and co-authored by other physicians and employees of the Heart Center. The hospital developed a nationally recognized standard of care for emergent heart attack patients; the article discussed this new standard in the delivery of heart attack care that produces outcomes which far exceed the national benchmarks. This presentation will outline this protocol and its development timeline, quality outcomes and benchmark standards in the delivery of care for heart attack patients.

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This session is an introduction to the concepts of electronically stored information and the content media involved, the topic of electronic medical records and the practical aspects of their use. It also will illustrate the positive and negative aspects of technology in different clinical and legal settings.

INA, CCM, LNCC

The legal nurse consultant is increasingly valuable in elder abuse cases. A legal nurse consultant team and an experienced elder law attorney will present the current issues and concerns of plaintiff long-term care and elder abuse cases. This session will present the process of how to prepare and litigate elder abuse and neglect case examples. The speakers will explain how these issues are found in acute care settings, home care settings, residential care and skilled nursing facilities. The presentation will include explanations of the CA Welfare and Institutions Code as it applies to elder abuse and the inclusive of punitive damages.

INA, CCM, LNCC

Learn about systems integration for the LNC practice, including ways to differentiate between independent practice and in-house practice and how current technology can increase efficiency and productivity. The presenters will discuss the importance of selecting the right equipment for business operations and external client needs, data management and storage and online repository design and usage. Online security and the effect of redundant backup systems also will be covered.

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This session will identify the National Quality Forum's list of Serious Reportable Adverse Events, also known as "Never Events," and how these relate to the CMS list of hospital-acquired conditions. On October 1, 2008, the CMS instituted a law that Medicare will no longer pay hospitals at a higher rate for increased costs when a patient is harmed by one of several conditions not present on admisson and determined to be reasonably preventable. The presenter will discuss the impact of this payment rule on hospitals and the process hospitals must utilize to reduce the incidence of such events to improve patient safety and avoid nonpayment. Further discussion on other mandatory and voluntary public healthcare reporting, the validity of such reports, and the impact on healthcare delivery and payment systems and healthcare consumers' choices also will be covered. Lastly, the presenter will discuss relevant discovery trails and the potential admissibility of these healthcare reports.

INA, CCM, LNCC

The Neonatal ICU is an area fraught with high risk for the clinician. However, careful attention to the fundamentals or neonatal care can serve to limit liabilty and multiple risk. The presentation is based on specific case studies involving clinical issues such as glucose homeostasis, airway management and mechanical ventilation, resuscitation algorithms and intravenous therapy.

INA, CCM, LNCC

Due to our aging population and advanced medical interventions, the incidence of pressure ulcers and iatrogenic wounds are on the rise. This has a direct correlation with a rise in wound-care-related litigation. This discussion will focus upon new developments in wound forensics, utilizing an expert witness and case studies citing chart analysis methodology. Particular focus will be based on hurdles in causation analysis. The attendee will gain a better understanding of standards of care in this arena and a better understanding of approaching wound-related cases.

INA, CCM, LNCC

The vast increase in the technology and demand of reproductive medicine has created ethical and complex legal challenges regarding indefinite embryo storage and abandonment issues. The speaker will present a broad overview of how an exciting LNC project was developed and completed when working in-house at a law firm to assist an attorney with providing legal counsel to a client inquiring about potential abandonment of frozen embryos. This session will discuss how an LNC's diverse and invaluable skill set can be utilized for much more than completing medical record chronologies!

INA, CCM, LNCC

The World Health Organization (WHO) predicts that motor vehicle accidents, war and violence will be the third-, eighth- and twelfth-leading causes of disability worldwide by the year 2020. Post Traumatic Stress Disorder (PTSD) is recognized as a sequelae of war, violence and accidents, including personal injury. It significantly impacts not only physical health and its associated healthcare costs, but also quality of life, degree of disability and pain and suffering. As these traumatic events increase, so follows the incidence of disabling PTSD; therefore, it is important that legal nurse consultants be familiar with the presenting symptoms and diagnosis of PTSD to enable them to appropriately advise attorneys seeking adequate compensation for their clients. This session will discuss diagnositc assessment tools and criteria for PTSD.

INA, CCM, LNCC

• Elder Abuse in Residential Care Facilities: How These Cases Differ from Skilled Nursing Allegations
  Tracy Albee, BSN RN LNCC CLCP FIALCP
  
• Creative Billing for the LNC
  Madeline God, MSN RN LNCC
  
• Timelines and Demonstrative Exhibits
  Mary Lou Hazelwood, RN LNCC
  
• Working with Experts - The Role of the In-house LNC
  Karen Huff, BSN RN LNCC
  
• Interview Techniques and Resume Hints to Land an LNC Job
  Suzanne Langroth, BSN RN LNCC
  
• The Plaintiff's In-house LNC Role in Personal Injury or Medical Malpractice Cases
  Sharon K. McQuown, MSN RN LNCC
  
• Analyzing Medical Records per Standards of Care
  Ginger Varca, BA RN

For 97 million Americans - more than one third of the adult population - being overweight or obese is a problem they face every day. But for 5 to 10 million people, the problem is much more serious. For these individuals considered morbidly obese, their weight is a serious impediment to their health, their activities and literally every aspect of their lives. The decision to have bariatric surgery involves working closely with the healthcare team to determine whether the patient is a good candidate for surgery, and whether he/she has a life-long commitment to lifestyle changes focused on health, nutrition, exercise and healthy living. This session will discuss how to screen patients for surgery, the latest procedures, the anatomy of the digestive system and post-operative complications in the immediate post-operative phase.

INA, CCM, LNCC

Many nurses want to leave the clinical area and use their knowledge outside the hospital. Workers Compensation case management can assist the nurse in developing skills as a legal nurse consultant, educating him/her about this interesting area of law and developing critical skills such as interviewing and time management.

INA CCM LNCC

This presentation will assist the LNC in learning how to locate the best qualified expert witnesses. Topics will include: the role of the LNC locating witnesses, critical steps in the location process, compliance with state statutes, how to approach and screen potential experts, communicating with attorneys to ensure an understanding of needs and managing expert witness data.

Concurrent Session #410
Triaging Trials: The Role of the In-house LNC for the Defense
Laura G. Nissim, RN MS CNS LNCC
Suzanne Smithwick, RN LNCC

The defense LNC's role is multifactorial in that it involves identification, preparation and guidance to attorneys and experts prior to and during trial. The LNC also provides a unique ability to identify pertinent exhibits and interpretation of testimony for defense use. The LNC's role has evolved from simple interpretation of the medical documentation to one of application of the analysis directly for trial use. This evolution of working hand-in-hand with the attorneys as part of the trial team affords the opportunity to provide an effective defense in all aspects of damage arguments. This session will discuss the issues above as well as compare the differences in how damages for trial pruposes are distinguished from pre-trial findings.

INA, CCM, LNCC

This session will review current and novel opioid delivery systems. It will highlight the potential liability issues that can arise with the use of these technologies and discuss the implications for LNCs. There will be several case examples and a brief discussion of emerging pain management standards.

INA, CCM, LNCC

Hear from AALNC Board of Directors in a panel presentation on finding work in a down economy. The panelists will address how the current economic climate has affected in-house work as well as independent practice, with suggestions for how to adapt to changing times. Board members from varied backgrounds will share their personal experiences, commenting on what has or has not worked for them with audience questions and discussion encouraged.

Hear an overview, in a point/counter point format, of the LNC role on opposing sides of a medical malpractice case, based on the real life experiences of two LNCs who have lived the roles. This humorous presentation will give examples of how varied an LNC's responsibilities can become. Educational discovery handouts will be provided. The practice differences between opposing LNCs in support of their attorney's litigation goals will be discussed.

INA, CCM, LNCC