Legal Implications in Nursing (WK9) Flashcards
What is a fiduciary relationship and how does it apply to nursing?
fiduciary relationship = trusting relationship;
One in which the nurse provides services that, by their nature, cause the recipient to trust in the specialized knowledge and integrity of the professional
Which government regulates the nursing profession? And how are they involved?
the provincial or territorial government
Regulatory bodies are responsible for:
- granting certificates of registration
- offering practice support
- ensuring continuing competence of their members
- investigating complaints
- disciplining members when necessary
- develop a code of ethics
- set standards of practice
- approve nursing programs
What are ‘standards of care’ and where do they arise from?
legal guidelines for nursing practice
come from a variety of sources:
- statutes
- case laws
- regulations
- practice standards
- code of ethics
How are standards of care used in a negligence lawsuit?
the standards are used to determine whether the nurse has acted as any reasonably prudent nurse in a similar setting w/ the same credentials would act
What is a ‘tort’?
a civil wrong committed against a person or property
can be intentional or unintentional
Intentional tort
willful acts that violate another person’s rights
- ex. assault, battery, invasion of privacy, false imprisonment
Unintentional tort
negligence
What is ‘Assault’?
Give a nursing example
- conduct that creates in another person apprehension of fear or imminent harmful or offensive contact
Ex.
- Threatening to give a pt an injection
- restraining a pt when pt refused consent
What is ‘Battery’?
Give a nursing example
- intentional physical contact w/o consent
- can be harmful, cause injury, or merely offensive to the pt’s dignity
Ex.
- giving an injection that was refused
What is ‘Invasion of Privacy?
- ex. releasing a pt’s medical info to an unauthorized person (ex. the pt’s employer, the press)
- tort of invasion of privacy protects the pt’s right to be free from unwanted intrusion into his/her private affairs
nurses have the duty to keep PHI confidential
When is it ok to breach confidentiality?
- when you suspect child abuse
- when there is a gunshot or stab wound
- when you receive a legal order to testify in court
- when the life, safety, or health of the pt or an innocent third party is in jeopardy (before releasing info to police, report to admin)
What should you do if your HIV-positive patient refuses to disclose this information to a blood bank where they recently donated blood?
Need to carefully weigh the need for privacy and confidentiality and the need for public safety
1) suggest and strongly encourage the pt to disclose this info
2) if refuses, seek consultation w/ professional colleagues and supervisors
What are ways in which you can avoid unintentional disclosure of confidential information about patients
- maintain professional boundaries
- follow employers’ policies
- do not post or share any patient-related info online
- do not make disparaging comments about employers or colleagues –> can be viewed as defamatory
What is ‘False Imprisonment’
Give a nursing example
- preventing a pt from leaving the health care facility voluntarily
- inappropriate/unjustified use of restraints
tort of false imprisonment serves to protect a person’s individual liberty and basic rights
What is Negligence
Harm resulting from inadvertence, thoughtlessness, inattention
the tort of negligence = MALPRACTICE
negligence in nursing is conduct that does not meet a standard of care established by law
What are some examples of negligence in nursing?
- medication errors resulting in harm
- IV therapy errors resulting in infiltrations or phlebitis
- burns caused by equipment, bathing, or spills of hot food
- falls
- failure to use aseptic technique
- failure to monitor a pt’s condition adequately
- failure to notify a physician of a significant change in a pts ststus
- failure to delegate properly or supervise
Can you be careful and still be negligent?
YES
- doing a procedure you haven’t done before and lack skills in is negligent
- courts define nursing negligence as the failure to use the degree of skill or learning ordinarily used under the same or similar circumstances by members of the nursing profession.
Criteria for negligence
Nurses can be found liable for negligence if:
- the nurse owed duty of care to the pt
- the nurse did not carry out that duty
- the pt was injured
- the nurse’s inaction caused the injury
How can you prevent negligence?
- follow the standards of care
- give competent health care
- insist on appropriate orientation, continuing education, and adequate staffing
- communicate w/ other HCPs
- develop a caring rapport w/ the pt
- document everything!!
What is the best defense against allegations of negligence?
careful, complete, and thorough documentation
if lost or incomplete; care is presumed to have been negligent
incomplete or illegible records undermine the credibility of the HCP
When is consent required
required for ALL routine treatment and procedures.
- General consent upon admission to the hospital
- special consent for specialized treatments or procedures
What factors make consent legally valid?
- must have the legal and mental capacity
- given voluntarily w/o coercion
- understand the risks and benefits of the procedure
- understand the risks of not undergoing the procedure
- aware of the alternatives to the procedure
Can family members help give consent when there is a communication barrier?
Technically yes, but should be the last resort
official interpreter should be used instead
What is Informed consent?
A person’s agreement to allow a medical action to happen, based on full disclosure of the likely risks and benefits of the action, alternatives to the actin, and the consequence of refusal