Legal Implications ch. 23

Quasi-intentional torts

Quasi-intentional torts are acts in which intent is lacking but volitional action and direct causation occur such as in invasion of privacy and defamation of character.

Regulatory Law (or Administrative law)

Reflects decisions made by administrative bodies such as State Boards of Nursing when rules and regulations are passed. An example of regulatory law is the requirement to report incompetent or unethical nursing conduct to the State Board of Nursing.

Assault

Assault is an intentional threat toward another person that places the person in reasonable fear of harmful, imminent, or unwelcome contact. No actual contact is required for awn assault to occur. For example: it is an assault for a nurse to threaten to give a patient an injection or to threaten to restrain a patient for an x-ray film procedure when the patient has refused consent. Likewise, it is an assault for a patient to threaten a nurse.

Felony

A felony is a serious offense that results in significant harm to another person or society in general. Felony crimes carry penalties of monetary restitution, imprisonment for greater than 1 year, or death. Examples of Nurse Practice Act violations that often carry criminal penalties include misuse of a controlled substance or practicing without a license.

Durable power of attorney for health care (DPAHC)

A health care proxy or durable power of attorney for health care (DPAHC) is a legal document that designates a person or people of one's choosing to make health care decisions when a patient is no longer able to make decisions on his or her own behalf. This agent makes health care treatment decisions on the basis of the patient's wishes.

Misdemeanor

A misdemeanor is a crime that causes injury but does not inflict serious harm. For example, parking in a no-parking zone is a misdemeanor violation of traffic laws. A misdemeanor usually has a penalty of a monetary fine, forfeiture, or brief imprisonment.

Good Samaritan Laws

All states have Good Samaritan laws to encourage health care professionals to assist in emergencies. These laws limit liability and offer legal immunity if a nurse helps at the scene of an accident. For example, if you stop at the scene of an automobile accident and give appropriate emergency care such as applying pressure to stop hemorrhage, you are acting within accepted standards, even though proper equipment is not available. If the patient subsequently develops complications as a result of your actions, you are immune from liability as long as you acted without gross negligence. However, you should only provide care that is consistent with your level of expertise.

Nurse Practice Acts

An example of state statutes are the Nurse Practice Acts found in all 50 states. Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state. The Nurse Practice Act of each state defines the scope of nursing practice and expanded nursing roles, sets education requirements for nurses, and distinguishes between nursing and medical practice.

Battery

Battery is any intentional offensive touching without consent or lawful justification. The contact can be harmful to the patient and cause an injury, or it merely can be offensive to the patients personal dignity. In the example of a nurse threatening to give a patient an injection without the patients consent, if the nurse actually gives the injection, it is battery. Battery also results if the health care provider performs a procedure that goes beyond the scope of a patients consent. The key component is the patients consent.

Occurrence report

Both quality improvement and risk management require thorough documentation. One tool used in risk management is the occurrence report or incident report. Occurrence reporting provides a database for further investigation in an attempt to determine deviations from standards of care, to identify corrective measures needed to prevent recurrence, and to alert risk management to a potential claim situation. Examples of an occurrence include patient or visitor falls or injury. An error in technique or procedure. Malfunction of device or product.

Common Law

Common law results from judicial decisions made by courts when individual legal cases are decided. An example of a common law includes informed consent, a patients right to refuse treatment, negligence, and malpractice.

Confidentiality

Confidentiality protects private patient information once it is disclosed in health care settings. Patient confidentiality is a sacred trust.

Defamation of Character

Defamation of Character is the publication of false statements that result in damage to a persons reputation.

Informed Consent

Informed consent is a patients agreement to have a medical procedure after receiving full disclosure of risks, benefits, alternatives, and consequences of refusal. Informed consent requires a health care provider to disclose information in terms a patient is able to understand to make an informed choice. Failure to obtain consent in situations other than emergencies can result in a claim of battery.

Libel

Libel is the written defamation of character. (Charting false entries in a medical record.)

Living wills

Living wills represent written documents that direct treatment in accordance with a patients wishes in the event of a terminal illness or condition. With this document a patient is able to declare which medical procedures he or she wants or does not want when terminally ill or in a persistent vegetative state. Living wills are often difficult to interpret and not clinically specific in unforeseen circumstances.

Malpractice

Malpractice is one type of negligence and often referred to as professional negligence. When nursing care falls below a standard of care, nursing malpractice results. Certain criteria are necessary to establish nursing malpractice: 1.) The nurse (defendant) owed a duty of care to the patient (plaintiff.) 2.) The nurse did not carry out or breached that duty. 3.) The patient was injured. 4.) The nurse's failure to carry out the duty caused the injury.

Negligence

Negligence is conduct that falls below the generally accepted standard of care of a reasonably prudent person. The law establishes the standard of care to protect others against an unreasonably great risk of harm. Negligent acts such as hanging the wrong intravenous solution for a patient often result in disciplinary action by the State Board of Nursing and a lawsuit for negligence against both the nurse and his or her employer.

Never Events

Never events are preventable errors, which may include falls, urinary tract infections from improper use of catheters, and pressure ulcers. The federal government and health care insurance companies have developed policies to withhold reimbursement for preventable medical errors. Know your agency policies and procedures to help develop a system and culture of patient safety.

Intentional torts

Nursing practice is also regulated by common law or judicial case law of torts. -Intentional torts are deliberate acts that violate another's rights such as assault, battery, and false imprisonment.

Torts

Nursing practice is also regulated by common law or judicial case law of torts. -Torts are civil wrongful acts or omissions made against a person or property. They are classified as intentional, quasi-intentional, or unintentional.

Privacy

Privacy is the right of patients to keep personal information from being disclosed.

Risk Management

Risk management involves several components, including identifying possible risks, analyzing them, acting to reduce the risks, and evaluation the steps taken to reduce them. TJC requires the use of quality improvement and risk-management procedures. Both quality improvement and risk management require thorough documentation. One tool used in risk management is the occurrence report or incident report.

Slander

Slander occurs when one speaks falsely about another. For example, if a nurse tells people erroneously that a patient has gonorrhea and the disclosure affects the patients business, the nurse is liable for slander.

Standards of Care

Standards of Care are the legal requirements for nursing practice that describe minimum acceptable nursing care. Standards reflect the knowledge and skill ordinarily possessed and used by nurses actively practicing in the profession. continue.....

Civil Laws

Statutory law is either civil or criminal. Civil laws protect the rights of individuals and provide for fair and equitable treatment when civil wrongs or violations occur. The consequences of civil law violations are fines or specific performance of good works such as public service. Nursing negligence or malpractice is an example of a civil law violation.

Criminal Laws

Statutory law is either civil or criminal. Criminal laws protect society as a whole and provide punishment for crimes, which are defined by municipal, state, and federal legislation. Criminal laws are separated into misdemeanors of felonies.

Statutory Law

The legal guidelines that nurses follow originally were derived from constitutional law, statutory law, regulatory law, and common law. -Elected legislative bodies such as state legislatures and the U.S. Congress create Statutory Law. -An example of state statutes are the Nurse Practice Acts found in all 50 states.

Unintentional tort

The third classification of tort is the unintentional tort, which includes negligence or malpractice.

False Imprisonment

The tort of false imprisonment occurs with unjustified restraint of a person without a legal reason. This occurs when nurses restrain a patient in a confined area to keep the person from freedom. False imprisonment requires that the patient be aware of the confinement. An unconscious patient has not been falsely imprisoned.

Invasion of privacy

The tort of invasion of privacy protects a patients right to be free from unwanted intrusion into his or her private affairs. HIPAA and HITECH Act privacy standards have raised awareness of the need for health care professionals to provide confidentiality and privacy. Typically invasion of privacy is the release of a patients medical info to an unauthorized person such as a member of the press, patients employer, or family.