Legal Issues Flashcards
Responsibility vs Accountability?
responsibility is the obligation within ones power or control
accountability is the obligation to report, explain, or justify something or an action.
What does liability mean?
it means a person has a legal responsibility and accountability
What type of law is the Nurse Practice Act?
Statutory Law - fl laws that are made by congress, legislatures, city and county. These laws provide a standard to be followed.
Who creates administrative laws?
State Board of Nursing - agencies can be granted additional power to create and implement polices
What is considered criminal law?
theft, homicide, sexual assault
- anything harmful that may be punished by fine or imprisonment
What is considered civil law?
negligence and malpractice
- rights and duties of private individuals and their property.
What are torts?
a tort addresses the actions or omissions that result in harm to another person or property.
What are intentional torts? What are considered intentional torts?
are done with the intent to cause harm or damage.
- assault and battery
- defamation
- false imprisonment
- invasion of privacy
What are unintentional torts? What are considered unintentional torts?
are done without the intent to cause harm or damage.
- negligence
- malpractice
- acts of omission
What is negligence?
any deviation from what a reasonable person would do in a particular circumstance.
- any injuries or damage without the intent to harm, but occur due to a deviation from rules/protocol/procedures etc.
What is professional negligence or malpractice?
the same as negligence but that the nurse who is a licensed professional will be held to higher standards - as a reasonable person who is competent and experienced in the nursing profession.
What are the 5 requirements to establish malpractice? What do they mean?
- patient must be owed a duty - meaning we owe the patient to provide them with care (we have a responsibility to follow standards of care for each patient)
- a breach in that duty occurs - meaning any deviation from those standards of care
- foreseeability - meaning the nurse should have anticipated the injury or harm (malpractice) to occur before they deviated from the standards of care
- causation - meaning the injury or damage must be able to be identified as a direct result in breach of duty.
- damages - which can be physical, emotional or financial
What is assault and battery?
assault - the threat that causes a person to fear they will be touched.
battery - the actual unauthorized touching that is harmful or offensive to a person.
What is defamation of character?
when someone damages another’s reputation
What is libel and slander?
libel - is written defamation. ex. writing subjective comments about the patient in the chart
slander - is verbal defamation, with spoken words. ex. speaking or gossiping, making subjective comments about a patient in an inappropriate way.
What is false imprisonment?
the unlawful restraint or detainment of another person against their will.
- a nurse has the duty to inform the patient of the hard the may cause by refusing care but cannot force care or restrain a competent adult from leaving.
What is invasion of privacy?
when an individuals private affairs are made public without consent. (includes health history and status)
a nurse has a legal and ethical duty to maintain patient confidentiality.
What does “respondeat superior” mean?
“let the master answer”
employers can be held liable for the employees negligence
What does “res ipsa loquitur” mean?
“the thing speaks for itself”
even if the harm or injury cannot be traced to a specific person, there is no way that the event could occur without some type of negligence.
What is the statute of limitations?
a law that sets a maximum timeframe fro which someone can wait before filling a lawsuit.
- this is why documentation is so important ! it could be years later.
What should you know and do as a charge nurse to avoid negligence?
- charge nurse and team members job descriptions
- complete formal training
- have validated proof of competencies
- know the guidelines for making patient assignments
- understand the chain of command
What are common reasons nurses get hit with a lawsuit?
MOST COMMON * failure to adequately monitor and assess patients (failure to rescue) *
SECOND MOST COMMON
* failure to follow standards of care *
- failure to follow orders or recognize a order error
- practicing outside their scope
- wrongful delegation
- failure to communicate, report, document, or notify the provider about a patients condition in a timely manner.
What is informed consent?
is the process in which a health care provider educates the patients on the risks and benefits of procedure of intervention so the patient can make a voluntary decision.
What does informed consent include?
- why the patient requires treatment
- why the procedure or intervention is needed
- how it will benefit the patient
- the positive and negative risks and outcomes
- how it will make the patient feel, or what they may experience
- any alternatives
What is the nurses role in informed consent?
the nurse is responsible for the verification that the patient is competent and of legal age.
the nurse is responsible for witnessing the patient sign the consent form in their presence.
IT IS THE PROVIDERS JOB TO EXPLAIN THE PROCEDURE OR INTERVENTION. NOT THE NURSE.
What are the competencies for consenting?
- 18 years or older
- not legally incompetent
- not temporarily incompetent, ie dementia or serious injury
anyone legally incompetent must have a legal guardian
What are emergency consents?
laws that permit life saving procedures when consent is impossible.
- has to be a procedure that any reasonable person would consent to if able and cannot be a procedure that was preciously declined by the patient.
- does not always apply
What is the criteria for delegating to a CNA?
- within scope of practice
- frequent routine care that involves little to no modifications from other patients
- may be performed according to a set of steps with a predictable outcome
- does not involve on going assessment or monitoring of the patient
- does not endanger the patients life or well being
What guidelines do we follow when practicing in a state?
we follow the laws or rules in whatever state we are working in (whatever state you are in, caring for that patient) regardless of your original state of licensure or where you reside.
What is protected under the HIPPA law?
- name, address, birth date, SSN, - any past present or future conditions whether physical or mental.
- any treatment or interventions received
- past, present or future payment for health care
- access to medical records
ANY OF THIS IS A BREECH OF CONFIDENTIALITY / INVASION OF PRIVACY
What is the nurse responsibility with the patients information?
only obtain important info of the patients under your care
only disclose patient information to other health care providers that are delivering direct patient care or to approved family/individuals
know that you are legally required to reports and stop others from discussing any patients private information inappropriately
Who is mandated to report observed or suspected abuse or neglect?
- all licensed professionals ie, doctors and nurses
- anyone who takes care of children ie, teachers, daycare
- all public safety workers ie, police officers, firefighters and EMT
What needs to be reported?
- bullet or gunshot wounds
- animal bites
- sharp object injures that may be criminal acts
- any wounds, injury or illness that may be acts of violence such as domestic violence
- any suspected abuse of children, older adults or disabled persons
- communicable diseases that could affect public health
- other nurses that are in violation of their states nurse practice act
When implementing a providers order what things do we need to clarify?
- any order a patient questions
- all orders after a change in the patients condition
- all verbal orders (record them!)
- any order that is illegible, unclear or incomplete.
GO DIRECTLY TO THE HCP FOR CLARIFICATION FIRST
How do we write incident or variance reports?
fill them out completely and accurately with objective facts.
- No assumptions, opinions, conclusions or blame.
report should include the patients account in direct quotes and identify all witnesses to the incident
DO NOT MAKE AN ENTRY IN THE PATIENTS CHART THAT AN INCIDENT REPORT WAS COMPLETED.
