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!