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Legal Aspects of Nursing

NUR101
FALL 2008
LECTURE #21
K. Burger, MSEd, MSN, RN,CNE
PPP by: Sharon Niggemeier RN MSN Revised kburger8/06
Legal Aspects

• Legal accountability for all nursing actions


rests with the nurse.

• Nurses and student nurses are legally


responsible for their actions
Regulation of Nursing Practice
• Regulated by laws
New York State Nurse Practice Act
Patient Self-determination Act (PSDA)
Health Insurance Portability and
Accountability Act ( HIPAA)
Americans with Disabilities Act ( ADA)
Medicaid Statutes / Resident’s Rights
Public Health Laws
Regulation of Nursing Practice
• Regulated by Standards of Care
guidelines developed by:
-nursing organizations such as ANA
-state boards of nursing
-health care institutions
-procedural textbooks
-written nursing policies/procedures
Mandated by the Joint Commission on
Accreditation of Healthcare Organizations
(JCAHO)
Licensure of Nursing Practice

• Licensure requirements are set by State


Board of Nursing

-educational requirements
-licensing exam (NCLEX)
-maintenance and renewal
-suspension and revocation
-professional misconduct proceedings
Take a look at www.op.nysed.gov/nurse.htm
The State Board of Nursing may revoke or
suspend a nurses license for willfully violating
the nurse practice act:
• drug/ETOH abuse (most common)
• fraud ( in obtaining license)
• conviction of a felony
• gross or ordinary negligence
• previous disciplinary actions in other states
• physical / mental impairments
• practicing after your license expires
Types of Legal Action- Crimes
• Criminal Action
– a wrong against persons and society
– criminal court
– punishable by imprisonment

Felony
Misdemeanor
Types of Legal Actions- Torts
• Civil Action- Tort
– A wrong against an individuals rights or
property
– civil court
– punishment usually with monetary settlement
– tort may also be a crime and tried in both courts
Intentional
Unintentional
Torts
• Intentional: • Unintentional:
fraud negligence
invasion of privacy Malpractice =
defamation of negligence as it
character applies to a
false imprisonment profession
assault and/or battery
Elements of Malpractice
FOUR elements must be • Injury(damages)-
met to prove guilty of nurses act caused harm
malpractice • Proximate cause-
• Duty- (relationship) reasonable cause and
nurses responsibility to effect can be shown
provide care in an between the omission
acceptable manner or commission and the
• Breach of Duty- failed harm
to provide care in
acceptable manner
Common Malpractice Allegations
• Failure to maintain safety
• Improper technique/treatment
• Failure to monitor and report
• Medication errors
• Failure to follow policy/procedures
• Poor documentation
• Improper use of equipment
Protecting Yourself

• Practice safely & competently


Always follow standards of care!!
• Develop a caring relationship with your pt
• Communicate, communicate, communicate!
• Document, document, document!
Protecting Yourself
• Remember - the nurse enters into a
contractual obligation ( ethical AND legal)
when caring for a client.
• You are responsible for the actions of your
ancillary staff ( Respondent superior )
• Carry your own liability insurance
• You have increased responsibility in regards
to Good Samaritan Laws.
Patient’s Bill of Rights
• Every patient has rights under PUBLIC
HEALTH LAW
See handout and/or

NYS Department of Health Website


Informed Consent
INCLUDES:
• Explanation of procedure
• Explanation of risks, anticipated discomfort
• Explanation of alternatives
Client has right to refuse
Client must be competent and of legal age
It is the physician’s duty to obtain informed consent
It is the nurse’s duty to verify that client was informed
Critical Thinking Exercise
While transporting a client down the hall on a
stretcher, Nurse Black stops to chat with an
orderly. The side rails on the stretcher are
down, and while Nurse Black has her back
to the stretcher, the client rolls over, falls off
the stretcher, and fractures his hip. In a
lawsuit by the client against Nurse Black,
what must the client establish to prove
negligence against the nurse ?

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