NURN 129 Health Law & Nursing

Effective delegation is based on the state Nurse Practice Acts and the understanding of the concepts of responsibility, authority, and accountability Delegation also requires critical thinking and professional judgment

Delegation and The Nurse Practice Acts

Five Rights of Delegation 1. right task 2. right circumstances 3. right person 4. right directions and communication 5. right supervision and evaluation

Delegation and The Nurse Practice Acts

State Government

Overview of US Government Basic Structure _____ Executive - Governor Legislative - Senate & House of Delegates Judicial - Court System -State Supreme Court -Court of Appeals -Trial Courts

Court System

Overview of US Government Federal Government Basic Structure Judicial - _____

President

Overview of US Government Federal Government Basic Structure Executive - _____

Trial courts

Overview of US Government Federal Government Basic Structure Judicial - Court System - U. S. Supreme Court - 13 Circuits - U.S.Courts of Appeals - _____

U.S.Courts of Appeals

Overview of US Government Federal Government Basic Structure Judicial - Court System - U. S. Supreme Court - 13 Circuits - _____ - Trial courts

13 Circuits

Overview of US Government Federal Government Basic Structure Judicial - Court System - U. S. Supreme Court - _____ - U.S.Courts of Appeals - Trial courts

U. S. Supreme Court

Overview of US Government Federal Government Basic Structure Judicial - Court System - _____ - 13 Circuits - U.S.Courts of Appeals - Trial courts

Senate & House of Representatives

Overview of US Government Federal Government Basic Structure Legislative - _____

Examples of Statutory Health Laws

Patient Self-Determination Act of 1990 (advanced directives)

The public is more informed than in the past - Factors Contributing to Liability Lawsuits

Patient's Bill of Rights/PBOR (1970's), Affordable Care Act (2010) now has the Patient Care Partnership that replaced the PBOR

Practice Acts - Provide guidelines to professional and social conduct

Define who may practice

Practice Acts - Provide guidelines to professional and social conduct

Define who may practice What qualifications are necessary Defines the scope (or limits) of practice

Malpractice

Defined as: A negligent act committed by a professional during his/her course of duty.

Negligence

Defined as: The failure of a responsible person to act in a reasonably prudent manner.

Practice Acts - Provide guidelines to professional and social conduct

Defines the scope (or limits) of practice

How to Avoid Malpractice liability

Delegate carefully - you are responsible

Emergency Medical Treatment and Active Labor Law ¡(EMTALA)

is a Federal law that requires anyone coming to almost any emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.

Reasonable behavior

is a comparison of a person's conduct compared to a hypothetical individual whose conduct represents society's ideal of reasonable behavior.

Negligence

is a failure to exercise the care that a reasonably prudent person would exercise in like circumstances. In tort law, negligence applies to harm caused by carelessness, not intentional harm. Negligence is the most common nursing tort.

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge.

The Emergency Medical Treatment and Active Labor Law

is a federal statute that was enacted in 1986 to prohibit the transfer of unstable clients, including women in labor, from one facility to another. This law also prohibits refusal of care for indigent and uninsured clients who seek medical assistance in the emergency department.

The Uniform Health Care Decisions Act of 1993

is a federal statute that was established to support individuals in expressing their preferences about medical treatment and making decisions about end-of-life care.

A category of civil law defined as: -Any legal wrong committed by one person on another person or another's property.

Torts

A category of civil law defined as: -Any legal wrong committed by one person on another person or another's property. Intentional - deliberate intention resulting in harm. Unintentional - unintentional torts are negligence

Torts

A category of civil law defined as: Intentional - deliberate intention resulting in harm. Unintentional - unintentional torts are negligence

Torts

is important for all nurses at every level of practice

Understanding the process of Risk Management _____.

Libel

is defined as comments that are written about a person that are defaming. Nurses may be subject to a charge of this for subjective comments meant to denigrate the client that are placed in the medical record or in other written materials read by others.

Malpractice

is professional negligence. Nurses should understand the areas of practice that most potentiate mistakes

Risk Management

is the duty of all nurses to improve practice and prevent injuries

Statutory Law - Statues

comes from legislation and are formally written Federal, State, or Local Legislators submit bills that can become law Examples of statues: - Maryland Nurse Practice Acts - Good Samaritan Laws - Medicare and Medicaid (Federal)

Durable power of attorney

involves preselection by the client of a person who has been authorized legally to make health care decisions once the client becomes incompetent to do so. Several states have enacted a Uniform Durable Power of Attorney Act, which sanctions a durable power of attorney for health care.

Unintentional torts (Overview of Common Causes of Nursing Negligence)

-Burns

Criminal law (Two Branches of Law Pertinent to Nursing)

-Could be a fine or could be jail time or both

How to Avoid Malpractice liability

Continually make a conscious effort to personalize patient care (therapeutic nurse-patient relationships)

Common Law (also called) Judicial Law

Court decisions set - precedent or prior law as bound by the doctrine of stare decisis*

Good Samaritan Law - Protection = Education

outside of employment setting

Intentional torts (Overview of Common Causes of Nursing Negligence)

-Defamation of character (verbal = slander; written = libel), derogatory statements in presence of a 3rd party

Damage

patient has suffered quantifiable damages as a result of the injury

Nurse Practice Acts

-Each state has Statutory Law that regulates the practice of nursing including the scope (permissible boundaries of professional practice)

Two Classifications (Branches) of Law Pertinent to Nursing

Criminal law

Examples of Standards of Care - Health Teaching

including assessment of learning needs, readiness to learn, plans to meet needs, implementation and evaluation

Sources of law

Common law

How to Avoid Malpractice liability

Consider purchasing malpractice insurance regardless of the area of nursing being practiced

Sources of law

Constitutional law

Sources of law

Constitutional law Statutory Law Common law

For it to be malpractice (not just negligence), four legal elements must be proven

(1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages.

Examples of Standards of Care

***Each licensed nurse should be familiar with the laws of their state, Standards of Care, and Violations of the Standard of Care.

Examples of Standards of Care

- Safety and Delegation

Intentional torts (Overview of Common Causes of Nursing Negligence)

-Assault (threatening to inflect harm)

Intentional torts (Overview of Common Causes of Nursing Negligence)

-Assault (threatening to inflect harm) -Battery (unprivileged touching of another) -False imprisonment (restraints) -Defamation of character (verbal = slander; written = libel), derogatory statements in presence of a 3rd party -Invasion of privacy (giving information to another without patient consent, failure to cover a patient, close a door, or curtain during a procedure can be considered a tort).

Intentional torts (Overview of Common Causes of Nursing Negligence)

-Battery (unprivileged touching of another)

Nurse Practice Acts

-Each state has Statutory Law that regulates the practice of nursing including the scope (permissible boundaries of professional practice) -Each state has rules known as administrative law to determine Standards of Care. -The Standard of Care lists each nursing practice area with examples of violations of said standards and sanctions for each violation. -Standard of Care is defined as: "those acts performed or omitted that an ordinary prudent person would have performed or omitted" and serve as a measure against which the nurse's conduct is compared.

Nurse Practice Acts

-Each state has rules known as administrative law to determine Standards of Care.

Criminal law (Two Branches of Law Pertinent to Nursing)

-Examples include mandatory reporting laws and criminal behavior by nurses outside of the workplace such as drug abuse that can result in license revocation.

Unintentional torts (Overview of Common Causes of Nursing Negligence)

-Failure to observe and report

Unintentional torts (Overview of Common Causes of Nursing Negligence)

-Falls

Intentional torts (Overview of Common Causes of Nursing Negligence)

-False imprisonment (restraints)

Intentional torts (Overview of Common Causes of Nursing Negligence)

-Invasion of privacy (giving information to another without patient consent, failure to cover a patient, close a door, or curtain during a procedure can be considered a tort).

Unintentional torts (Overview of Common Causes of Nursing Negligence)

-Medication errors

Unintentional torts (Overview of Common Causes of Nursing Negligence)

-Medication errors -Falls -Burns -Operating equipment incorrectly (not knowing how to use it, using defective equipment) -Not maintaining a safe environment (electrical hazards, spills, not changing light bulbs that have burned out, etc.) -Failure to observe and report

Unintentional torts (Overview of Common Causes of Nursing Negligence)

-Not maintaining a safe environment (electrical hazards, spills, not changing light bulbs that have burned out, etc.)

Criminal law (Two Branches of Law Pertinent to Nursing)

-Offensive conduct against the public

Unintentional torts (Overview of Common Causes of Nursing Negligence)

-Operating equipment incorrectly (not knowing how to use it, using defective equipment)

Criminal law (Two Branches of Law Pertinent to Nursing)

-Remedy for criminal offense is punishment

Nurse Practice Acts

-Standard of Care is defined as: "those acts performed or omitted that an ordinary prudent person would have performed or omitted" and serve as a measure against which the nurse's conduct is compared.

Nurse Practice Acts

-The Standard of Care lists each nursing practice area with examples of violations of said standards and sanctions for each violation.

Five Rights of Delegation - Delegation and The Nurse Practice Acts

1. right task 2. right circumstances 3. right person 4. right directions and communication 5. right supervision and evaluation

Protection

= Education

Violations of rights and perceived substandard care - The public is more informed than in the past - Factors Contributing to Liability Lawsuits

= seeking of monetary compensation.

Americans with Disabilities Act of 1990

A law passed in 1990 that requires employers and public facilities to make "reasonable accommodations" for people with disabilities and prohibits discrimination against these individuals in employment.

Failing to report elder abuse can lead to penalty of fine or imprisonment.

A nursing student planning to apply for licensure knows that being charged with which offense would result in a minor criminal offense?

Examples of Statutory Health Laws

AIDS laws

Examples of Statutory Health Laws

AIDS laws Abuse laws Emergency Medical Treatment and Active Labor Law (EMTALA) Americans with Disabilities Act of 1990 Patient Self-Determination Act of 1990 (advanced directives) Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Statutory Law Examples

AIDS laws and new Hepatitis C Law During the early years of the HIV epidemic, a number of states implemented HIV-specific criminal exposure laws. Some of these state laws criminalize behavior that cannot transmit HIV and apply regardless of actual transmission. As of 2018, 26 states had laws that criminalize HIV exposure. HIV Risk Behaviors The laws for the 50 states and the District of Columbia were assessed and categorized into five categories. HIV-specific criminal laws criminalize behaviors that can potentially expose another to HIV. STD/communicable/infectious disease criminal laws criminalize behaviors that can potentially expose another to STD/communicable/infectious diseases. This might include HIV. Sentence enhancement specific to HIV are laws that do not criminalize a behavior but increase the sentence length when a person commits certain crimes while infected with HIV. Sentence enhancement specific to STD are laws that do not criminalize a behavior but increase the sentence length when a person commits certain crimes while infected with an STD. This might include HIV. No HIV criminalization laws.

Examples of Statutory Health Laws

Abuse laws

Statutory Law Examples

Abuse laws The Federal Child Abuse Prevention and Treatment Act (CAPTA) requires each State to have provisions or procedures for requiring certain individuals to report known or suspected instances of child abuse and neglect.1 For this publication, information regarding mandatory reporting laws was collected for all States. The results indicate that all States, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands identify in statute the professionals and other persons who are required to report instances of suspected child maltreatment. These statutes also address reporting by other persons, the responsibilities of institutions in making reports, standards for making a report, and confidentiality of the reporter's identity.

How to Avoid Malpractice liability

Accurately document all nursing assessments using the nursing process.

How to Avoid Malpractice liability

Administer Meds carefully (8 rights) / check orders

risk managers!

All nurses should be risk managers!_____.

Examples of Statutory Health Laws

Americans with Disabilities Act of 1990

malfunction or failure of medical equipment

Circumstances under which an incident report should be filed include _____ .

Two Classifications (Branches) of Law Pertinent to Nursing

Civil law

Two Classifications (Branches) of Law Pertinent to Nursing

Civil law Criminal law

Standards of Care

Any time a nurse provides care to a person, the formation of a nurse-patient relationship is established

Overview of US Government

Basic Structure Federal Government Executive - President Legislative - Senate & House of Representatives Judicial - Court System -U. S. Supreme Court -13 Circuits -U.S.Courts of Appeals -Trial courts

How to Avoid Malpractice liability

Be familiar with institutional polices and procedures

How to Avoid Malpractice liability

Be familiar with the NPA of your state

How to Avoid Malpractice liability

Be familiar with the NPA of your state Be familiar with institutional polices and procedures Don't accept assignments you cannot perform Delegate carefully - you are responsible Administer Meds carefully (8 rights) / check orders Do not offer opinions Take steps to prevent falls

How to Avoid Malpractice liability

Do not offer opinions

How to Avoid Malpractice liability

Don't accept assignments you cannot perform

Membership of the board of nursing

Duties of the board of nursing

The State Board of Nursing BON

Each state's legislature establishes regulatory agencies to implement and enforce the Nurse Practice Acts (which define, monitor and regulate the nursing profession)

The public is more informed than in the past - Factors Contributing to Liability Lawsuits

Educated from media

The public is more informed than in the past - Factors Contributing to Liability Lawsuits

Educated from media Health promotion mindset - no longer content for HCP to make all the decisions regarding care Prefer partnering, being an active participant, demanding quality Patient's Bill of Rights/PBOR (1970's), Affordable Care Act (2010) now has the Patient Care Partnership that replaced the PBOR Violations of rights and perceived substandard care = seeking of monetary compensation.

Examples of Statutory Health Laws

Emergency Medical Treatment and Active Labor Law (EMTALA)

Today's Nursing and The Law

Evolution from traditional roles (nurturing and menial tasks) to contemporary practice of: Higher knowledge requirements

Malpractice

Example - a nurse administering the wrong medication to a patient would be negligent in carrying out her duty and therefore would be guilty of malpractice

Common Law (also called) Judicial Law

Example: Roe v. Wade - set law for abortion rights (law that came down through a court decision)

Assessment

Examples of Standards of Care

Assessment Safety and Delegation Communication Health Teaching

Examples of Standards of Care

Communication

Examples of Standards of Care

Health Teaching

Examples of Standards of Care

Safety and Delegation

Examples of Standards of Care

Statutory Law - Statues

Examples: - Maryland Nurse Practice Acts - Good Samaritan Laws - Medicare and Medicaid (Federal)

Overview of US Government - Basic Structure - State Government

Executive - Governor Legislative - Senate & House of Delegates Judicial - Court System - State Supreme Court - Court of Appeals - Trial Courts

Overview of US Government - Basic Structure - Federal Government

Executive - President Legislative - Senate & House of Representatives Judicial - Court System - U. S. Supreme Court - 13 Circuits - U.S.Courts of Appeals - Trial courts

Statutory Law - Statues

Federal, State, or Local Legislators submit bills that can become law

Civil law (Two Branches of Law Pertinent to Nursing)

Financial awards

Practice Acts

General rules intended to safeguard the public welfare Provide guidelines to professional and social conduct

Statutory Law Examples

Good Samaritan Laws

Risk Management

Handles all incidents, claims, and other insurance-related tasks.

Examples of Statutory Health Laws

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

The public is more informed than in the past - Factors Contributing to Liability Lawsuits

Health promotion mindset - no longer content for HCP to make all the decisions regarding care

4 elements of negligence - Elements of Malpractice

If any one of the legal concepts of negligence is not proven - the case is dismissed in the pretrial stage

Responsibilities of Risk Management

Incident Reports - ANY injury, problem, mistake that puts the facility at risk for legal action

Responsibilities of Risk Management

Incident Reports - ANY injury, problem, mistake that puts the facility at risk for legal action Using Standardized procedures - SBAR / TIME OUT Reporting Sentinel Events - Adverse events that cause severe or fatal injuries All nurses should be risk managers!

The expanded role of the nurse - Factors Contributing to Liability Lawsuits

Increasing complex tasks

The expanded role of the nurse - Factors Contributing to Liability Lawsuits

Independent implementation of the nursing process

Malpractice

Is a type of negligence; it is often called "professional negligence". It occurs when a licensed professional (like a doctor, lawyer, accountant, or nurse) fails to provide services as per the standards set by the governing body ("standard of care"), subsequently causing harm to the plaintiff. For it to be malpractice (not just negligence), four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages.

Court of Appeals

Overview of US Government Basic Structure State Government Executive - Governor Legislative - Senate & House of Delegates Judicial - Court System -State Supreme Court -_____ -Trial Courts

How to Avoid Malpractice liability

Keep your nursing license current and easily accessible

can help prevent professional negligence (Malpractice)

Knowing the expected Standards of Care _____.

Common Law (also called) Judicial Law

Laws determined by court decisions

Common Law (also called) Judicial Law

Laws determined by court decisions Court decisions set - precedent or prior law as bound by the doctrine of stare decisis* Malpractice is often decided by common law (prior court decisions that have been made) Example: Roe v. Wade - set law for abortion rights (law that came down through a court decision)

Civil law (Two Branches of Law Pertinent to Nursing)

Legal rights and duties of private citizens

Civil law (Two Branches of Law Pertinent to Nursing)

Legal rights and duties of private citizens Remedy for civil offense is compensation Financial awards

How to Avoid Malpractice liability

Maintain a level of expertise and competency by keeping up to date (life long learning)

How to Avoid Malpractice liability

Maintain a level of expertise and competency by keeping up to date (life long learning) Possess at least a basic knowledge of the law and its affects on nursing practice Continually make a conscious effort to personalize patient care (therapeutic nurse-patient relationships) Keep your nursing license current and easily accessible Accurately document all nursing assessments using the nursing process. Consider purchasing malpractice insurance regardless of the area of nursing being practiced

The expanded role of the nurse - Factors Contributing to Liability Lawsuits

Making professional judgments/decisions about nursing care

Common Law (also called) Judicial Law

Malpractice is often decided by common law (prior court decisions that have been made)

Statutory Law Examples

Maryland Maryland law defines domestic violence "abuse" as the occurrence of one or more of the following acts between "family or household members": Assault An act that places a person in fear of imminent serious bodily harm An act that causes serious bodily harm Rape or sexual offense Attempt rape or sexual offense Stalking False imprisonment, such as interference with freedom, physically keeping you from leaving your home or kidnapping you.

Trial Courts

Overview of US Government Basic Structure State Government Executive - Governor Legislative - Senate & House of Delegates Judicial - Court System -State Supreme Court -Court of Appeals -_____

Court System

Overview of US Government Basic Structure State Government Executive - Governor Legislative - Senate & House of Delegates Judicial - _____ -State Supreme Court -Court of Appeals -Trial Courts

Senate & House of Delegates

Overview of US Government Basic Structure State Government Executive - Governor Legislative - _____ Judicial - Court System -State Supreme Court -Court of Appeals -Trial Courts

State Supreme Court

Overview of US Government Basic Structure State Government Executive - Governor Legislative - Senate & House of Delegates Judicial - Court System -_____ -Court of Appeals -Trial Courts

Governor

Overview of US Government Basic Structure State Government Executive - _____ Legislative - Senate & House of Delegates Judicial - Court System -State Supreme Court -Court of Appeals -Trial Courts

Statutory Law Examples

Maryland Elder Abuse Laws The purpose of the law is to prevent or remedy neglect, self-neglect, abuse, or exploitation of vulnerable adults who are unable to protect their own interests and are at risk of immediate harm to their own person or to others. The following definitions are very important: Vulnerable Adult - a person aged 18 or over who lacks the physical or mental capacity to provide for her or his daily needs. Neglect - the willful deprivation of adequate food, clothing, medical treatment, or habilitative therapy, shelter, or supervision from a vulnerable adult. Self-Neglect - the inability of a vulnerable adult to provide for his/her physical or mental health and well-being. Abuse - the sustaining of any physical injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by any person, Exploitation - any action which involves the misuse of a vulnerable adult's funds, property, or person. Read the Law: MD Code Family Law § 14-101 It is also a crime for anyone responsible for the supervision of a vulnerable adult to neglect or abuse the person. Any abuse or neglect that results in sexual abuse, serious harm, or death is classified as felony of abuse or neglect of a vulnerable adult in the first degree and is punishable by up to 10 years in prison and up to $10,000 in fines. Any abuse or neglect not rising to first degree abuse or neglect of a vulnerable adult may still be prosecuted as misdemeanor of abuse or neglect of a vulnerable adult in the second degree. On conviction, misdemeanor of abuse or neglect of a vulnerable adult in the second degree is punishable by up to five years in prison and up to $5,00

Membership of the board of nursing

Membership of the board of nursing

Membership of the board of nursing

Membership of the board of nursing Duties of the board of nursing

The State Board of Nursing BON - Each state's legislature establishes regulatory agencies to implement and enforce the Nurse Practice Acts (which define, monitor and regulate the nursing profession)

National Council of State Boards of Nursing - https://www.ncsbn.org/index.htm

require intent to harm another person.

Neither negligence, nor malpractice ____.

Expert witness testimony

Nurse Practice Acts These standards are defined by:

Individual institutional/facility policies and procedures

Nurse Practice Acts These standards are defined by:

Previous court rulings

Nurse Practice Acts These standards are defined by:

Professional nursing organizations (i.e. The American Nurses Association or ANA)

Nurse Practice Acts These standards are defined by:

Statues (laws) and codes, job descriptions

Nurse Practice Acts These standards are defined by:

The Joint Commission (hospital accrediting body)

Nurse Practice Acts These standards are defined by:

legally bound

Nurses are _____ to report critical incidents to their nurse managers, agency administration, and risk manager through a formal intra-agency document generally titled the "incident report."

The expanded role of the nurse - Factors Contributing to Liability Lawsuits

Nurses doing duties once relegated to the MD

The expanded role of the nurse - Factors Contributing to Liability Lawsuits

Nurses doing duties once relegated to the MD Increasing complex tasks Independent implementation of the nursing process Making professional judgments/decisions about nursing care

Negligence

One of the most common nursing torts

Examples of Standards of Care - Communication

including significant changes in the patient condition to the healthcare team

How to Avoid Malpractice liability

Possess at least a basic knowledge of the law and its affects on nursing practice

The public is more informed than in the past - Factors Contributing to Liability Lawsuits

Prefer partnering, being an active participant, demanding quality

Civil law (Two Branches of Law Pertinent to Nursing)

Remedy for civil offense is compensation

Responsibilities of Risk Management

Reporting Sentinel Events - Adverse events that cause severe or fatal injuries All nurses should be risk managers!

Doctrines

Result from Judicial Opinions

Risk Management Best Practices

Sentinel Events - are adverse events that cause severe or fatal injuries (think about Josie King)

Standards of Care

This relationship has legal implications: once initiated it holds the nurse to a certain professional standard of care

Examples of Standards of Care - Assessment

including subjective, objective data regarding health status of the client

The State Board of Nursing BON - Each state's legislature establishes regulatory agencies to implement and enforce the Nurse Practice Acts (which define, monitor and regulate the nursing profession)

State Boards also: approve educational programs, determine licensure, re-licensure, educational requirements, and discipline nurses.

The State Board of Nursing BON - Each state's legislature establishes regulatory agencies to implement and enforce the Nurse Practice Acts (which define, monitor and regulate the nursing profession)

State Boards of Nursing do not have the power or right to make nursing laws, however, they are charged with enforcing existing laws

The State Board of Nursing BON - Each state's legislature establishes regulatory agencies to implement and enforce the Nurse Practice Acts (which define, monitor and regulate the nursing profession)

State Boards of Nursing do not have the power or right to make nursing laws, however, they are charged with enforcing existing laws State Boards also: approve educational programs, determine licensure, re-licensure, educational requirements, and discipline nurses. National Council of State Boards of Nursing - https://www.ncsbn.org/index.htm

Sources of law

Statutory Law

How to Avoid Malpractice liability

Take steps to prevent falls

HIPAA

The Health Insurance Portability and Accountability Act

Patient Self-Determination Act of 1990 (advanced directives)

The PSDA requires all health care agencies (hospitals, long-term care facilities, and home health agencies) receiving Medicare and Medicaid reimbursement to recognize the living will and power of attorney for health care as advance directives.

the plantiff

The complaining person in a lawsuit is _____.

includes the nature of the therapy or procedure, expected benefits and outcomes of the therapy or procedure, potential risks of the therapy or procedure, alternative therapies to the intended procedure and their risks and benefits, and risks of not having the procedure.

The information that constitutes informed consent for the client

State laws have been created as a result of the 1973 Child Abuse Prevention and Treatment Act.

These laws dictate that health professionals must report infant and child abuse and specified communicable diseases. Failure by the nurse to comply can result in fines and/or imprisonment.

Responsibilities of Risk Management

Using Standardized procedures - SBAR / TIME OUT

The public is more informed than in the past - Factors Contributing to Liability Lawsuits

Violations of rights and perceived substandard care = seeking of monetary compensation.

Considerations for nursing conduct include: i.e. greater level of education and experience holds a nurse to a higher standard of care; nurses practicing in a specialty are all held to the same standards of that specialty practice; an RN is compared to another RN, not to an LPN.

What is Reasonable Nursing Care?

Considerations for nursing conduct include: Knowledge, skill, education, experience, and available resources

What is Reasonable Nursing Care?

Courts use Standards of Care to determine if reasonable (expected) nursing care was rendered

What is Reasonable Nursing Care?

Courts use Standards of Care to determine if reasonable (expected) nursing care was rendered Considerations for nursing conduct include: Knowledge, skill, education, experience, and available resources i.e. greater level of education and experience holds a nurse to a higher standard of care; nurses practicing in a specialty are all held to the same standards of that specialty practice; an RN is compared to another RN, not to an LPN. RN Nursing Students are held to the standard of an RN student in a court of law.

What is Reasonable Nursing Care?

RN Nursing Students are held to the standard of an RN student in a court of law.

What is Reasonable Nursing Care?

Knowledge, skill, education, experience, and available resources

What is Reasonable Nursing Care? Considerations for nursing conduct include:

i.e. greater level of education and experience holds a nurse to a higher standard of care; nurses practicing in a specialty are all held to the same standards of that specialty practice; an RN is compared to another RN, not to an LPN

What is Reasonable Nursing Care?Considerations for nursing conduct include:

Practice Acts - Provide guidelines to professional and social conduct

What qualifications are necessary

A written physician's order that is timed and dated is required for the use of restraints. Renewal of orders must be accompanied by evidence of medical evaluation and nursing reassessment.

When can a nurse detain a client by using restraints?

State laws have been created as a result of the 1973 Child Abuse Prevention and Treatment Act. These laws dictate that health professionals must report infant and child abuse and specified communicable diseases. Failure by the nurse to comply can result in fines and/or imprisonment.

Which types of abuse are the nurse required to report or be subject to fines and imprisonment for not reporting?

Standards of Care

come from the state Nurse Practice Acts - every nurse should know these laws

Statutory Law - Statues

comes from legislation and are formally written

Good Samaritan Laws by state

You need to understand whether or not you will be protected and what you can and cannot do to afford yourself of the protection. The statutes that are quoted below are just part of the statute. Consequently you should find the entire law and find out how it affects you. Yellow highlight is interesting language Green highlights are very interesting language in the statute Red Text is important language defining whether it is only medical care or medical and emergency/rescue care. Pink highlight is where must the first aid training come from or the standard of first aid training that the Samaritan must use. Red highlight is language that is restrictive or of major concern. Turquoise highlighting is restrictive language. Blue highlighting is language covering AED's Gray Highlighting is language covering epinephrine

Membership of the board of nursing - Duties of the board of nursing

administering the state's Nurse Practice Act

Membership of the board of nursing - Duties of the board of nursing

administering the state's Nurse Practice Act granting and renewing licenses taking disciplinary action approving schools of nursing

Membership of the board of nursing - Maryland Board of Nursing

appointed by the Governor's office

Membership of the board of nursing - Duties of the board of nursing

approving schools of nursing

Most HC Laws

are State laws

Sentinel Events

are adverse events that cause severe or fatal injuries (think about Josie King)

Nurse Practice Acts (NPA) (Nurse Practice Acts & Malpractice)

are from statutory law meaning that all states and territories in the United States have enacted a nurse practice act (NPA). Each state's NPA is passed by the state's legislature.

Punitive damages

are monetary compensation to an injured client that is greater than amount of loss.

Standards of Nursing Practice

are statements established by the American Nurses Association and made law in each states Nurse Practice Act

The Nurse Practice Acts

are statues that define nursing practice, licensure requirements, standards for education, and authorize the state board of nursing

Health Care laws

come from Statutes, Common Law (court decisions), or the Bill of Rights (Constitutional law).

Doctrines

create the rules or standards that comprise legal doctrine

4 elements of negligence - Elements of Malpractice

damage

4 elements of negligence - Elements of Malpractice

direct cause -causation

Advance directives

document an individual's desires regarding end-of-life care. These wishes are generally stated through the execution of a formal document known as the living will. Right-to-die statutes vary from state to state; therefore, nurses must become familiar with their state-specific statute.

4 elements of negligence - Elements of Malpractice

duty

4 elements of negligence - Elements of Malpractice

duty duty breach direct cause -causation damage

4 elements of negligence - Elements of Malpractice

duty breach

Good Samaritan Law

effective October 1, 2015, provides protection from arrest as well as prosecution for certain specific crimes and expands the charges from which people assisting in an emergency overdose situation are immune. If someone calls 911 in an effort to help during an overdose crisis, or they are experiencing an overdose, their parole and probation status will not affected, and they will now not be arrested, charged, or prosecuted for: ​Possession of a controlled dangerous substance​​ Possession or use of drug paraphernalia Providing alcohol to minors

The National Quality Forum

identified the process of disclosure as a key element of the national patient safety movement.

Good Samaritan Law - Protection = Education

emergency situation

Intentional(Torts) (A category of civil law defined as:)

examples are defamation of character, trespassing (Note: YouTube video on your class overview has an excellent discussion of torts)

Unintentional (Torts) (A category of civil law defined as:)

examples are leaving a surgical sponge in a body cavity or throwing a football through your neighbor's window

Delegation of client care tasks

falls within the role of the team leader, and inappropriate delegation of client care tasks could result in negligence. Team leaders, charge nurses, and managers are held to the standard of care of the reasonably prudent nurse employed in that role.

Constitutional law (Sources of law)

from the constitution and refers to the U.S. Constitution and the Bill of Rights which guarantees individual fundamental rights. Example: the amendments provide for rights to: privacy, speech, religion, etc.

Statutory Law (Sources of law)

from the constitution of the United States and includes the Bill of Rights which guarantees individual fundamental rights such as privacy, speech, and religion. from legislation (We'll get a closer look at these laws when we look at the Nurse Practice Acts)

Common law (Sources of law)

from the courts decisions

Membership of the board of nursing - Duties of the board of nursing

granting and renewing licenses

Risk Management

has traditionally focused on the important role of patient safety and the reduction of medical errors that jeopardize an organization's ability to achieve its mission and protect against financial liability

Abuse laws

health care practitioners, educator, human service worker & law enforcement officer are required to report both orally and in writing any suspected child abuse or neglect.

Risk Management

healthcare risk management has traditionally focused on the important role of patient safety and the reduction of medical errors that jeopardize an organization's ability to achieve its mission and protect against financial liability. hospitals and other healthcare systems are expanding their risk management programs from ones that are primarily reactive and promote patient safety and prevent legal exposure, to ones that are increasingly proactive and view risk through the much broader lens of the entire healthcare ecosystem.

Risk Management

hospitals and other healthcare systems are expanding their risk management programs from ones that are primarily reactive and promote patient safety and prevent legal exposure, to ones that are increasingly proactive and view risk through the much broader lens of the entire healthcare ecosystem.

Risk Management

identification, analysis, evaluation, and elimination or reduction of risks to hospital visitors, patients, or employees.

Risk Management

identification, analysis, evaluation, and elimination or reduction of risks to hospital visitors, patients, or employees. Handles all incidents, claims, and other insurance-related tasks.

Standard of care

is the legal criteria against which the nurse's (and physician's) conduct is compared to determine whether a negligent act or malpractice occurred. Nurses are specialists in hospital care who, in the final analysis, hold the well-being—in some instances, the very lives—of patients in their hands.

Good Samaritan Laws

legal terms refers to someone who renders aid in an emergency to an injured person on a voluntary basis. Usually, if a volunteer comes to the aid of an injured or ill person who is a stranger, the person giving the aid owes the stranger a duty of being reasonably careful. A person is not obligated by law to do first aid in most states, not unless it's part of a job description. However, some states will consider it an act of negligence though, if a person doesn't at least call for help. Generally, where an unconscious victim cannot respond, a good samaritan can help them on the grounds of implied consent. However, if the victim is conscious and can respond, a person should ask their permission to help them first.

4 elements of negligence - Elements of Malpractice

must be proven before any malpractice suit may go to trial

Good Samaritan Law - Protection = Education

nurse rendering assistance

Duty

nurse-patient relationship established and created a duty to provide care

Good Samaritan Law - Protection = Education

protection from malpractice

Good Samaritan Law - Protection = Education

protection from malpractice nurse rendering assistance emergency situation outside of employment setting

HIPAA

protects patient information and ensures confidentiality of data.

Direct cause - causation

relationship between the breach and the injury

Doctrines

represent the legal rules applied by judges in courts of law.

AIDS laws

requires reporting of HIV and AIDS cases

Five Rights of Delegation (Delegation and The Nurse Practice Acts)

right circumstances

Five Rights of Delegation (Delegation and The Nurse Practice Acts)

right directions and communication

Five Rights of Delegation (Delegation and The Nurse Practice Acts)

right person

Five Rights of Delegation (Delegation and The Nurse Practice Acts)

right supervision and evaluation

Five Rights of Delegation (Delegation and The Nurse Practice Acts)

right task

Duty Breached

standard of care not met

Membership of the board of nursing - Duties of the board of nursing

taking disciplinary action

Health Care Law

the collection of laws that have a direct impact on the delivery of healthcare or on the relationships among those in the business of health care or between the providers and recipients of health care.

The nurse must articulate

to the client the dangers associated with leaving the facility if the primary provider is not present. The nurse's notes on this form should reflect the specific advice given to the client, which should include the fact that leaving the facility could aggravate the current condition and complicate future care, result in permanent physical or mental impairment or disability, or result in complications that can cause death.