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.
