Legal Implications for Nursing

1. Legal Implications for Nursing

2. 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

3. 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

5. 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

6. 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

7. 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

8. 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

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

10. 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

11. 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

12. Liability • Burns • Hot water • Heating pads • Heating lamps • Sitz bath

13. 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 pt’s 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 pt’s condition

15. 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

16. 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

17. 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 patient’s primary language

18. 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

19. 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!