Ch45 1 legal concepts

JUDITH M. WILKINSON LESLIE S. TREASKAREN BARNETT MABLE H. SMITH

FUNDAMENTALS OFFUNDAMENTALS OFNURSINGNURSING

Copyright © 2016 F.A. Davis Company

Chapter 45: Chapter 45: Legal AccountabilityLegal Accountability


Laws

• Established to protect society• Nursing practice guided by legal principles• Purpose of laws

– Protect clients/society– Define scope of nursing practice– Identify minimum level of care to be provided


Sources of Law

• U.S. Constitution• Federal and state legislatures• Administrative agencies• Courts


Federal Laws Guiding Nursing Practice• Bill of Rights• Emergency Medical Treatment and Active

Labor Act• Americans With Disabilities Act


Federal Laws Guiding Nursing Practice (cont’d)

• Patient Self-Determination Act• Health Insurance Portability and

Accountability Act (HIPAA)


ClickerCheckOn admission to Hospital A, the patient indicates that he would like information about making a living will. The nurse informs the patient that the hospital does not have a process in place to facilitate this. Hospital A is not in compliance with the

a.Health Insurance Portability and Accountability Actb.Emergency Medical Treatment and Active Labor Actc.Americans with Disabilities Actd.Patient Self-Determination Act


ClickerCheck (cont’d)

Correct answer: D

The Patient Self-Determination Act requires healthcare agencies to provide information to patients about formulating advanced directives. A living will is a type of advanced directive.


State Laws Guiding Nursing Practice

• Mandatory reporting laws– Communicable disease– Abuse

• Good Samaritan laws– Differ by state

• Nurse practice acts– Credentialing– Licensing– Discipline


Standards of Practice

• Standard of care– What a reasonable and prudent nurse would do

in the same or a similar scenario• Derived from

– Nurse practice acts – Professional organizations – The Joint Commission


Other Guidelines for Nursing Practice• Institutional polices and procedures• Nursing codes of ethics• Patient care partnership• ANA Nurses’ Bill of Rights


ClickerCheck

There are no legal consequences for nurses who do not follow the ANA Standards of Professional Performance as these are not laws.

a.Trueb.False



Correct answer: B

The ANA Standards of Care are one “group” of professional nursing standards that define what a reasonable and prudent nurse would do in a practice environment. In a court of law, a nurse could be found guilty of negligence for failing to do what a reasonable and prudent nurse would do.


Criminal Law

• Federal or state government prosecutes• Offense against society• Can lead to a fine, imprisonment, or death

– Misdemeanor• Minor crime; DUI

– Felony• Homicide


Civil Law

• Allows for resolution of dispute between private parties

• May result in monetary compensation• Plaintiff: person bringing suit• Defendant: person being sued


Types of Civil Law

• Contract law– Dealing with agreements between individuals– Explicit or implicit

• Tort law– Dealing with duties and rights among

individuals– Involves claims for damages


Torts and Nursing Practice

• Quasi-Intentional Torts– Defamation

• False communication to a third person– Slander

• Oral defamatory statements– Libel

• Written defamatory statements


Torts and Nursing Practice (cont’d)

• Intentional torts– Assault and battery

• Performing a procedure without consent

– False imprisonment• Restraining a client against his or her will

– Fraud• Failing to provide essential information for

informed consent– Invasion of privacy

• Breach of confidentiality


ClickerCheck

Trina, an RN on the nursing unit, states to the student nurse, “I see you are working with Beth today. Make sure you watch your patient carefully because I think Beth is one of our worst nurses.” The student knows that this statement could be considered

a.Libelb.Slanderc.Fraudd.Invasion of privacy



Correct answer: B

The nurse has made an oral statement to another person reflecting only her opinion that may cause harm to her colleague’s reputation.



• Negligence• Failure to perform as a reasonable, prudent

person would• Failure to follow standards of practice• No intent to harm is present



• Malpractice• Professional form of negligence• Four elements necessary to collect

damages– Existence of a duty– Breach of the duty– Causation– Damages


Common Malpractice Claims

• Failure to assess and diagnose

• Failure to plan• Failure to implement a plan

of care• Failure to evaluate


Minimizing Malpractice Risk

• PROPER DOCUMENTATION• Observe standards of practice.• Use nursing process; follow professional

standards.• Avoid medication and treatment errors.• Report and document accurately.• Obtain informed consent.• Attend to client safety.


Minimizing Malpractice Risk (cont’d)

• Maintain client confidentiality.• Provide education and counseling.• Delegate, assign, and supervise properly.• Accept appropriate assignments.• Participate in continuing education.• Observe professional boundaries.• Observe mandatory reporting regulations.• Be aware of legal safeguards for nurses.


Think Like a NurseA 54-year-old uninsured and unemployed female arrives at the emergency department (ED) of a small private hospital complaining of chest pain and nausea. The triage nurse calls the on-call physician, who instructs the nurse to send the patient to the county hospital several blocks away. The nurse assesses the patient and contacts her supervisor who instructs her to contact the medical chief of staff to inform him that the patient is in need of emergency treatment.

•Discuss whether the nurse’s action was appropriate or inappropriate.

Date post:	18-Feb-2017
Category:	Health & Medicine
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Ch45 1 legal concepts

Health & Medicine