Nursing Liability

1
Nursing Liability

• NURS 2221
• L D Andrews

2
Nurse Practice Act

• Scope of Practice
• Categories of Practice
• Educational and Exam requirements
• Establishes Board
• protect the public
• regulate practice

3
Professional Malpractice

• Duty Owed the Client
• existence and nature
• standard of care
• Breach of Duty
• expert witness
• Foreseeability
• Causation
• Injury
• Prove Damages

4
Nurse Manager Role

• Know applicable standards of care
• Ensure all employees meet or exceed standards
• Periodically update standards
• Routine performance evaluations to determine if
  employees are performing at minimum standard

5
Liability Personal, Vicarious, Corporate

• Personal Liability
• Substitute, Vicarious
• Respondeat Superior
• Indemnification
• Corporate
• negligent hiring and firing
• safety
• maintenance of qualified staff

6
Nurse Manager Role

• Ensure staff remains competent and qualified
• Current licensure
• Appropriate reporting of incompetent, illegal or
  unethical practices
• Safe environment

7
Causes of Malpractice for Nurse Managers

• Delegation and Supervision
• Duty to Orient, Educate and Evaluate
• Failure to Warn
• Staffing Issues

8
Delegation and Supervision

• Nurse manager personally liable
• failure to properly delegate and supervise
• malpractice
• corporate liability
• knew or should have known
• duty to ensure subordinates are safe
• know subordinates knowledge, skills, competencies

9
Duty to Orient, Educate, Evaluate

• Daily evaluation of safe, competent care
• reasonableness
• prompt response to allegations of incompetent or
  questionable care

10
Failure to Warn

• Warning of potential employers of staff
  incompetence or impairments
• Check with agency policy and state law

11
Staffing Issues

• Adequate Staff
• Guidelines
• Reporting, chain of command
• Action by upper management
• Floating
• Guidelines
• Cross-training
• Temporary Staff
• apparent agency
• assignment responsibilities of manager

12
Strict Product Liability

• Defective Equipment v. Misuse
• Nurse Manager
• equipment properly used
• maintained properly
• follow manufacturers guidelines
• record and report maintenance
• investigate equipment problems

13
Protective and Reporting Lays

• Protective
• child and elder abuse
• diseases and injuries
• Incompetent Nursing Practice

14
Informed Consent

• Legal age or emancipated minor
• check state minors treated for substance abuse,
  communicable diseases, and pregnancy
• Voluntary Action
• Comprehension
• Right to refuse

15
Privacy and Confidentiality

• Privacy
• name or picture seclusion or affairs false
  light disclosure of private facts
• Confidentiality
• right to privacy of the medical record
• Manager
• adhere to policy, instruct staff
• patient right to access to medical record
• incident reports

16
Policies and Procedures

• Agency written policies and procedures
• requirement of JCAHO
• review periodically

17
Employment Laws

• Equal Employment Opportunity Laws
• Civil Rights Act, 1964, 1991
• Exceptions
• Americans with Disabilities Act, 1990
• Affirmative Action
• Occupational Safety and Health Act
• Employment at Will
• exceptions