Chpt 7 : Legal Dimensions of Nursing Practice

Reasons for Suspending or Revoking a License

1. Drug or alcohol abuse 2. Fraud 3. Deceptive practice 4. Criminal acts 5. Previous disciplinary actions 6. Gross or ordinary negligence 7. Physical or mental impairments including age

Four Elements of Liability

1. Duty 2. Breach of Duty : Failure to Act or doing excessive action outside of scope of practice. Like an LPN doing RN work. 3. Causation: + Failure to use appropriate safety measures 4. Damages

Nurse's Best Defense of License Investigation

1. Early legal counseling 2. Character and expert witnesses 3. Thorough preparation for all proceedings

Categories of Malpractice Claims

1)Failure to follow standards of care 2)Failure to use equipment in responsible manner 3)Failure to assess and monitor 4)Failure to communicate 5)Failure to document 6)Failure to act as a patient advocate

3 outcomes of Malpractice Litigation

1. All parties work toward fair settlement 2. Case is presented to malpractice arbitration panel 3. Case is brought to trial court

During a nursing shift, which events warrant completion of an incident report? Select all that apply.

1. An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. 2. A visitor slipped and fell in the hallway, but was not injured. 3. A client falls while being transferred from the bed to the chair.

The nurse recognizes that liability requires specific elements that must be established to prove that malpractice or negligence has occurred. Identify the specific elements. Select all that apply.

1. Causation 2. Damages 3. Duty 4. Breach of duty

Legal Safeguards for Nurses

1. Competent practice 2. Informed consent or refusal 3. Contracts 4. Collective bargaining 5. Patient education 6. Executing physician orders 7. Documentation 8.Delegating nuring care 9. Appropriate use of social media

Roles of Nurses in Legal Proceedings

1. Defendant. 2. Fact witness. 3. Expert witness.

Safeguards to Competent Practice

1. Developing interpersonal communication skills 2. Respecting legal boundaries of practice 3. Following institutional procedures and policies 4. Owning personal strengths and weaknesses 5. Evaluating proposed assignments 6. Keeping current in nursing knowledge and skills 7. Respecting patient rights and developing rapport with patients 8. Keeping careful documentation 9. Working within agency for management policies

Elements of Informed Consent

1. Disclosure 2. Comprehension 3. Competence 4. Voluntariness

Recommendations for Nurse Defendant

1. Don't discuss the case with those involved 2. Don't alter patient records 3. Cooperate fully with your attorney 4. Be courteous on witness stand 5. Don't volunteer any information

Public Law

1. Government is directly involved; -regulates relationships between individuals and government

Information Contained in Incident Reports

1. Name of person & witnesses 2. Factual account of incident 3. Date, time, and place of incident 4. Pertinent characteristics of person involved 5. Any equipment or resources being used 6. Any other important variables 7. Documentation by physician of medical examination of person involved

Unintentional

1. Negligence 2. Malpractice

Due Cause for Revoking a License

1. Notice of investigation 2. Fair and impartial hearing 3. Proper decision based on substantial evidence

Professional & Legal Regulation of Nursing Practice

1. Nurse Practice Acts 2. Standards 3. Credentialing ( Accreditation, Licensure, Certification)

Laws affecting nursing practice

1. Occupational Safety and Health (OSHA) 2. National Practitioner Data Bank 3. Reporting obligations 4. Controlled substances 5. Discrimination and sexual harassment 6. Health Insurance Portability and Accountability Act (HIPAA) 7. Restraints 8. People with disabilities 9. Legal issues related to death and dying (wills, advance directives)

Types of Risk Management Programs

1. Safety program 2. Products safety program 3. Quality assurance programs.

Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What is an example(s) of legal safeguards for the nurse? Select all that apply.

1. The nurse confirms informed consent was give by the client to perform a procedure. 2. The nurse educates the client about what to expect during the hospital stay. 3.The nurse documents all client care in a timely manner.

HIPAA-Ensured Patient Rights

1. To see and copy their health record 2. To update their health record 3. To request correction of any mistakes 4. To get a list of the disclosures a health care institution has made independent of disclosures made for the purposes of treatment, payment, and health care operations 5. To request a restriction on certain uses or disclosures 6. To choose how to receive health information

OSHA Legal Regulations

1. Use of electrical equipment 2. Use of isolation techniques 3.Use of radiation 4.Use of chemicals

Legal Safeguards for Nurses Cont.

1.Adequate Staffing 2. Whistle blowing 3. Professional Liability Insurance 4.Risk management programs 5. Just culture 6. Incident, variance, or occurrence reports ( Sentinel events and never events) 7. Patients' rights 8. Good Samaritan Laws 9. Student liability

Intentional

1.Assault and battery 2.Defamation of character 3.Invasion of privacy 4.False imprisonment 5.Fraud

Tort

A wrong committed by a person against another or ones property; tried in civil court ( Intentional or Unintentional)

Criminal Law

Concerns state & federal criminal statutes (Defines criminal actions " Murder, theft")

Which statement about laws governing the distribution of controlled substances is true?

Nurses are responsible for adhering to specific documentation about controlled substances.

Misdemeanor

Punishable by fines or less than 1 year imprisonment

Felony

Punishable by imprisonment for more than 1 year

Private Law (Civil Law)

Regulate relationships among people

Nurse practice acts are examples of which type of laws?

Statutory laws

T or F: Informed consent is a process

True

T or F: Living wills are recognized universally in the U.S

True

Crime

Wrong against a person or the persons property as well as the public