1. Legal Aspects of Nursing NUR101 FALL 2008 LECTURE #21 K. Burger, MSEd, MSN, RN,CNE PPP by: Sharon Niggemeier RN MSN Revised kburger8/06

2. Legal Aspects Legal accountability for all nursing actions rests with the nurse. Nurses and student nurses are legally responsible for their actions

3. Regulated by laws New York State Nurse Practice Act Patient Self-determination Act (PSDA) Health Insurance Portability and Accountability Act ( HIPAA) Americans with Disabilities Act ( ADA) Medicaid Statutes / Resident’s Rights Public Health Laws New York State Nurse Practice Act Regulation of Nursing Practice

4. Regulated by Standards of Care guidelines developed by: -nursing organizations such as ANA -state boards of nursing -health care institutions -procedural textbooks -written nursing policies/procedures Mandated by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

5. Licensure of Nursing Practice Licensure requirements are set by State Board of Nursing -educational requirements -licensing exam (NCLEX) -maintenance and renewal -suspension and revocation -professional misconduct proceedingsprofessional misconduct proceedings Take a look at www.op.nysed.gov/nurse.htmwww.op.nysed.gov/nurse.htm

6. The State Board of Nursing may revoke or suspend a nurses license for willfully violating the nurse practice act: drug/ETOH abuse (most common) fraud ( in obtaining license) conviction of a felony gross or ordinary negligence previous disciplinary actions in other states physical / mental impairments practicing after your license expires

7. Types of Legal Action- Crimes Criminal Action –a wrong against persons and society –criminal court –punishable by imprisonment Felony Misdemeanor

8. Types of Legal Actions- Torts Civil Action- Tort –A wrong against an individuals rights or property –civil court –punishment usually with monetary settlement –tort may also be a crime and tried in both courts Intentional Unintentional

9. Torts Intentional: fraud invasion of privacy defamation of character false imprisonment assault and/or battery Unintentional : negligence Malpractice = negligence as it applies to a profession

10. Elements of Malpractice FOUR elements must be met to prove guilty of malpractice Duty- (relationship) nurses responsibility to provide care in an acceptable manner Breach of Duty- failed to provide care in acceptable manner Injury(damages)- nurses act caused harm Proximate cause- reasonable cause and effect can be shown between the omission or commission and the harm

11. Common Malpractice Allegations Failure to maintain safety Improper technique/treatment Failure to monitor and report Medication errors Failure to follow policy/procedures Poor documentation Improper use of equipment

12. Protecting Yourself Practice safely & competently Always follow standards of care!! Develop a caring relationship with your pt Communicate, communicate, communicate! Document, document, document!

13. Protecting Yourself Remember - the nurse enters into a contractual obligation ( ethical AND legal) when caring for a client. You are responsible for the actions of your ancillary staff ( Respondent superior ) Carry your own liability insuranceliability insurance You have increased responsibility in regards to Good Samaritan Laws.

14. Patient’s Bill of Rights Every patient has rights under PUBLIC HEALTH LAW See handout and/or NYS Department of Health Website NYS Department of Health Website

15. Informed Consent INCLUDES: Explanation of procedure Explanation of risks, anticipated discomfort Explanation of alternatives Client has right to refuse Client must be competent and of legal age It is the physician’s duty to obtain informed consent It is the nurse’s duty to verify that client was informed

16. Critical Thinking Exercise While transporting a client down the hall on a stretcher, Nurse Black stops to chat with an orderly. The side rails on the stretcher are down, and while Nurse Black has her back to the stretcher, the client rolls over, falls off the stretcher, and fractures his hip. In a lawsuit by the client against Nurse Black, what must the client establish to prove negligence against the nurse ?