Transcript Legal Implications for Nursing

Legal Implications for
Nursing
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
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Duty
Breach of duty
Harm
Causation
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
Legal Terms
• Harm
– The patient has been injured in some way
• Causation
– The breach of duty caused the harm
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
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
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
Liability
• Common sources of liability
– Most malpractice claims come from routine
functions
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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
Liability
• Falls
– Identify pt who is at risk for a fall and take
action
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Blind
Elderly
Sedated
Dizzy
Confused
Immediately post-op
Liability
• Document use of
– Restraints
– Side rails
– Monitoring of pt
• Use care with restraints
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Side rails are considered a restraint
May be chemical or physical
Should use the least restrictive method
Continually monitor the pt
Careful documentation
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
Liability
• Burns
– Hot water
– Heating pads
– Heating lamps
– Sitz bath
Liability
• Failure to observe
– Keep monitors on the pt
– Monitor vital signs after administration of
pain meds
– Monitor pt closely and report any
complications
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
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
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
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
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
• 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!