Legal Responsibilities

Legal Responsibilities HS-IHS-9 The student will explain the legal responsibilities, limitations, and implications of their actions within the healthcare delivery setting. They will perform their duties according to regulations, policies, laws and legislated rights of clients. The student will explain the legal responsibilities, limitations, and implications of their actions within the healthcare delivery setting. They will perform their duties according to regulations, policies, laws and legislated rights of clients.

Legal Responsibilities HS-IHS-9a Analyze the basic legal responsibilities of healthcare workers in regards to torts, malpractice, negligence, invasion of privacy, privileged communication, patient /client confidentiality, doctrine of informed consent including identification of HIPAA regulations and the impact on healthcare communications. Analyze the basic legal responsibilities of healthcare workers in regards to torts, malpractice, negligence, invasion of privacy, privileged communication, patient /client confidentiality, doctrine of informed consent including identification of HIPAA regulations and the impact on healthcare communications.

Legal Responsibilities HS-IHS-9a What is a tort? What is a tort? A tort is a wrongful or illegal act of civil law NOT involving a contract. A tort is a wrongful or illegal act of civil law NOT involving a contract. A tort occurs when a healthcare worker does not meet the established or expected standards of care. A tort occurs when a healthcare worker does not meet the established or expected standards of care. What is civil law? What is civil law? Civil law focuses on legal relationships between people and the protection of a person’s rights. Civil law focuses on legal relationships between people and the protection of a person’s rights.

Legal Responsibilities HS-IHS-9a Examples of torts: Examples of torts: Malpractice Malpractice Negligence Negligence Assault and battery Assault and battery Invasion of privacy Invasion of privacy False imprisonment False imprisonment Abuse Abuse Defamation Defamation

Legal Responsibilities HS-IHS-9a What is criminal law? What is criminal law? Criminal law deals with wrongs against a person, property, or society. Criminal law deals with wrongs against a person, property, or society. Examples of criminal offenses include: Examples of criminal offenses include: Practicing without required license Practicing without required license Misuse of narcotics Misuse of narcotics Theft Theft Murder Murder

Malpractice Literally interpreted as “bad practice” Literally interpreted as “bad practice” Commonly called “professional negligence” Commonly called “professional negligence” Definition: failure of a professional to use the degree of skill and learning commonly expected in a particular profession, resulting in injury, loss or damage to the person receiving the care Definition: failure of a professional to use the degree of skill and learning commonly expected in a particular profession, resulting in injury, loss or damage to the person receiving the care

Malpractice Examples include: Examples include: Nurse performing surgery without any training. Nurse performing surgery without any training. Physician administering inappropriate medication for a patient. Physician administering inappropriate medication for a patient.

Negligence Definition: failure (neglect) to give care that is normally expected of a person in a particular position. Definition: failure (neglect) to give care that is normally expected of a person in a particular position. Examples include: Examples include: Falls and injuries that occur when side rails are left down. Falls and injuries that occur when side rails are left down. Using defective equipment. Using defective equipment.

Assault and Battery Assault: a threat or attempt to injure. Assault: a threat or attempt to injure. Battery: unlawful touching of another person without consent. Battery: unlawful touching of another person without consent. Assault and battery are closely related and often used together. Assault and battery are closely related and often used together.

Assault and Battery Remember that patients must give consent and have the right to refuse care. Remember that patients must give consent and have the right to refuse care. Some procedures require written consent from the patient. Some procedures require written consent from the patient. Examples: performing a procedure after patient has refused to give permission; improper handling and rough treatment of a patient. Examples: performing a procedure after patient has refused to give permission; improper handling and rough treatment of a patient.

Informed Consent Permission granted voluntarily by a person who is of sound mind and after the procedure and all risks involved have been explained in terms the patient understands. Permission granted voluntarily by a person who is of sound mind and after the procedure and all risks involved have been explained in terms the patient understands.

Invasion of Privacy Unnecessary exposure of a patient Unnecessary exposure of a patient Revealing personal information about a patient without consent Revealing personal information about a patient without consent Examples: Improperly draping or covering a patient during a procedure that allows others to see the exposed patient; sending information to an insurance company without written consent; informing the news media about a patient’s condition. Examples: Improperly draping or covering a patient during a procedure that allows others to see the exposed patient; sending information to an insurance company without written consent; informing the news media about a patient’s condition.

False Imprisonment Refers to restraining an individual or restricting an individual’s freedom. Refers to restraining an individual or restricting an individual’s freedom. Examples: Keeping a patient hospitalized against his will (patient has the right to decide to leave AMA); applying physical restraints without proper authorization Examples: Keeping a patient hospitalized against his will (patient has the right to decide to leave AMA); applying physical restraints without proper authorization

False Imprisonment – Special Notes About Restraints Two types of restraints: chemical and physical Two types of restraints: chemical and physical Chemical restraints are medications used to affect patient behavior; examples: tranquilizers, sedatives Chemical restraints are medications used to affect patient behavior; examples: tranquilizers, sedatives Physical restraints are protective devices that limit a patient’s movement. Physical restraints are protective devices that limit a patient’s movement. Restraints should be used ONLY to protect patients from harming themselves or others, and when all other measures have failed. Restraints should be used ONLY to protect patients from harming themselves or others, and when all other measures have failed.

False Imprisonment – Special Notes About Restraints There must be an explicit doctor’s order for restraint. There must be an explicit doctor’s order for restraint. Least restrictive device must be tried first. Least restrictive device must be tried first. Restraints must be removed q2h for at least 10 minutes, with ROM and skin care provided. Restraints must be removed q2h for at least 10 minutes, with ROM and skin care provided. Restraint applied unnecessarily can be considered FALSE IMPRISONMENT. Restraint applied unnecessarily can be considered FALSE IMPRISONMENT.

Abuse Abuse is any care that results in physical harm, pain, or mental anguish. Abuse is any care that results in physical harm, pain, or mental anguish. Abuse may occur before a patient is seen by a healthcare professional, and must be reported to proper authorities. Abuse may occur before a patient is seen by a healthcare professional, and must be reported to proper authorities. Signs include: unexplained bruises, fractures, burns, signs of neglect (poor hygiene, malnutrition), irrational fears, aggressive or withdrawn behavior Signs include: unexplained bruises, fractures, burns, signs of neglect (poor hygiene, malnutrition), irrational fears, aggressive or withdrawn behavior

Abuse – Four Categories Physical: hitting; inflicting bodily harm or injury; forcing someone against his/her will; deprivation (such as sleep, food, water) Physical: hitting; inflicting bodily harm or injury; forcing someone against his/her will; deprivation (such as sleep, food, water) Verbal: speaking harshly, swearing or shouting, abusive statements, threats Verbal: speaking harshly, swearing or shouting, abusive statements, threats Psychological: threatening harm, denying rights, belittling, intimidating, ridiculing Psychological: threatening harm, denying rights, belittling, intimidating, ridiculing Sexual: sexual touching, using sexual gestures, suggesting sexual behaviors Sexual: sexual touching, using sexual gestures, suggesting sexual behaviors

Defamation FALSE statements either cause a person to be ridiculed or damage a patient’s reputation. FALSE statements either cause a person to be ridiculed or damage a patient’s reputation. If the information is spoken, it is slander. If the information is spoken, it is slander. If it is written, it is libel. If it is written, it is libel. Examples: gossip about a patient, exaggerating or embellishing actual events; reporting inaccurate diagnosis for publication, such as a church prayer list Examples: gossip about a patient, exaggerating or embellishing actual events; reporting inaccurate diagnosis for publication, such as a church prayer list

Privileged Communication Privileged communication is comprised of all information given to health care personnel by a patient; by law this information must be kept confidential and shared only with other members of the patient’s health team on a “need to know” basis. Privileged communication is comprised of all information given to health care personnel by a patient; by law this information must be kept confidential and shared only with other members of the patient’s health team on a “need to know” basis. It cannot be told to anyone else without written consent, including health insurance companies. It cannot be told to anyone else without written consent, including health insurance companies.

Patient / Client Confidentiality Confidentiality means that information about the patient must remain private and can be shared only with other members of the healthcare team. Confidentiality means that information about the patient must remain private and can be shared only with other members of the healthcare team. A legal violation can occur if the patient suffers personal or financial damage when confidential information is shared with others, INCLUDING FAMILY MEMBERS! A legal violation can occur if the patient suffers personal or financial damage when confidential information is shared with others, INCLUDING FAMILY MEMBERS!

HIPAA HEALTHINSURANCE PORTABILITY and ACCOUNTABILITY ACT of 1996

HIPAA Three Primary Provisions of HIPAA: 1. Standardization of electronic patient health, administrative and financial data. 2. Unique health identifiers for individuals… (similar to your student I.D. number). 3. Security standards protecting the CONFIDENTIALITY AND INTEGRITY of “individually identifiable health information”, past, present or future.