Legal Implications for Nursing

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Legal Implications for Nursing
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Legal Terms

• Negligence
• A general term that refers to conduct that does
  not show due care
• Occurs when someone fails to do something that a
  reasonably prudent person would do in a similar
  situation
• Four essential characteristics
• Duty
• Breach of duty
• Harm
• Causation

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Legal Terms

• Duty
• Duty of a professional toward an individual
• That duty is established when the nurse patient
  relationship is started
• Breach of duty
• Nursing care fell below acceptable standards or
  the nurse was negligent

4
Legal Terms

• Harm
• The patient has been injured in some way
• Causation
• The breach of duty caused the harm

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Legal Terms

• Malpractice
• Specific type of negligence
• Applied to professionals who fail to follow a
  standard of care prevalent for the profession and
  thereby harms another person
• Ranges from being negligent when caring for a
  patient to betraying a confidence

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Legal Terms

• Standard of Care
• Level of care a reasonably prudent nurse would
  have maintained
• Standards of care change with each new medical
  advance
• Must keep up with the latest information in your
  field
• Must read journals, attend conferences
• Be familiar with the policy and procedure manuals
  and clinical pathways in your facility

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Legal Terms

• Liability
• And obligation or debt that can be enforced by
  law
• In cases of malpractice a person found guilty of
  a tort is considered legally liable, or legally
  responsible for the outcome

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Liability

• Common sources of liability
• Most malpractice claims come from routine
  functions
• Falls
• Medication errors
• Burns
• Failure to observe
• Failure to notify MD
• MDs failure to respond
• Violation of policies and procedures
• Defective equipment
• Improper pt teaching

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Liability

• Falls
• Identify pt who is at risk for a fall and take
  action
• Blind
• Elderly
• Sedated
• Dizzy
• Confused
• Immediately post-op

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Liability

• Document use of
• Restraints
• Side rails
• Monitoring of pt
• Use care with restraints
• Side rails are considered a restraint
• May be chemical or physical
• Should use the least restrictive method
• Continually monitor the pt
• Careful documentation

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Liability

• Medication errors
• Perhaps 98,000 Americans dies each year from med
  errors
• Remember the five rights
• Right patient, drug, dose, time, route
• Check the med label three times before
  administering the med
• Know the correct dose
• Know the correct route
• Know the potential side effects
• Clarify any order with the physician who ordered
  the drug

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Liability

• Burns
• Hot water
• Heating pads
• Heating lamps
• Sitz bath

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Liability

• Failure to observe
• Keep monitors on the pt
• Monitor vital signs after administration of pain
  meds
• Monitor pt closely and report any complications

14
Liability

• Failure to notify the physician
• Must communicate any pertinent information to the
  pts MD in a timely manner
• Must speak with MD, not leave messages
• Should go up the chain of command if unable to
  get MD
• Notify MD if there is a change in the pts
  condition

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Liability

• Physician's failure to respond
• If you feel that the MD does not respond in a
  satisfactory manner, must notify the supervisor,
  hospital administrator, or medical director

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Liability

• Violation of policies and procedures
• You are responsible for knowing them
• Defective equipment
• Must select the appropriate equipment for a
  particular pt or procedure
• Maintain that equipment
• Use the equipment properly
• Report any problems immediately

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Liability

• Improper patient teaching
• Liable for what you teach or fail to teach
• Give written instructions to reinforce the verbal
  instructions
• Document teaching in the chart
• Must provide it in the patients primary language

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Incident Reports

• Allows hospital administration to identify
  problems within the hospital system
• Alert administration of an event that may end up
  in a lawsuit
• Important to fill out one to identify problematic
  situations and create a safe environment
• Keep statements factual, objective, do not draw
  conclusions
• Do not mention incident report in charting
• May or may not be allowed into court

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• Remember that patients who feel that doctors and
  nurses have done their best are not as likely to
  sue as a patient who feels ignored or neglected
• A little kindness goes a long way!