Professional Documents
Culture Documents
Legal Aspects of Nursing: Nelia B. Perez RN, MSN Pcu - MJCN
Legal Aspects of Nursing: Nelia B. Perez RN, MSN Pcu - MJCN
Nursing
Nelia B. Perez RN, MSN
PCU - MJCN
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
Specific Examples
Failure to report observations to
attending physicians
Failure to exercise the degree
of diligence which the
circumstances of the particular
case demands
Mistaken identity
Wrong medicine, wrong
concentration, wrong route,
wrong dose
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
MEDICAL ORDERS,
DRUGS and
medications.
RA 6675
Only validly registered
medical, dental and
veterinary practitioners,
whether in private institution,
corporation or in the
government, are authorized
to prescribed drugs.
RA 6675
Requires that the drug be written in their
generic names.
Only when these orders are legal
writing and bear the doctors signature
thus the nurse have the legal right to
follow them
The nurse must not execute an order if
she is reasonably certain it will result in
harm to the patient.
TELEPHONE ORDERS
Only in an extreme emergency and when
no other resident or intern is available
should a nurse receive telephone orders.
The nurse should read back such order to
the physician to make certain the order
has been correctly written.
Such order should be sign by the
physician on his next visit within 24 hours.
MEDICAL RECORDS
Supplies rich material for medical and
nursing research
Serves as a legal protection for the
hospital, doctor, and nurse by reflecting
the disease or condition of the patient and
his management.
if it was not charted, it was not observed
or done.
CONTINUATION..
Nurses are expected to record fully,
accurately, legibly and promptly their
observations from admission to the time of
the patients discharge.
Nurses are legally and ethically bound to
protect the patients chart from
unauthorized person.
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
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
Blind
Elderly
Sedated
Dizzy
Confused
Immediately post-op
Liability
Document use of
Restraints
Side rails
Monitoring of pt
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
Policy
Probity
Peril
Punishment
Preservation
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 pts 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
pts 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 patients
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
TORT
Definition
A tort is a legal wrong,
committed against a person or
property independent of a
contract which renders the
person who commits it liable for
damages in a civil action.
Examples
Defamation.
Slander is oral defamation of a
person by speaking unprivileged
or false words by which his
reputation is damaged.
Libel is defamation by written
words, cartoons or such
representations that cause a
person to be avoided, ridiculed, or
held in contempt or to tend to
injure him in his work
CRIMES
Crime defined
It is an act committed or omitted
in violation of the law. It is
composed of two elements: (1)
criminal act and (2) evil/criminal
intent
Criminal Liability
Exempting circumstances
- an imbecile or insane person, unless
the latter has acted during a lucid interval.
-below 9 years old
-over 9 years of age and under fifteen
unless he/she acted with discernment
Mitigating circumstances
Are those which do not constitute
justification or excuse of the offense in
question, but which in fairness and
mercy, may be considered as
extenuating degree of moral culpability.
Aggravating circumstances
Alternative circumstances
-are those which must be taken into
consideration as aggravating or mitigating
according to the nature and effects of the
crime and other conditions attending in
commission.
Should be taken consideration when the
offended party is the spouse, ascendant
or descendant, legitimate, natural or
adopted or relatives.
Principals
Are those who take a direct part in the
execution of the act; who directly force or
induce others to commit; or who cooperate
in the commission of the offense by
another act without which it would not
have been accomplished.
Accomplices
Are those persons who, not being
principals, cooperate in the execution in
the offense by previous or simultaneous
act.
Accessories
Are those who, having knowledge of the
commission of the crime, either as
principals or accomplices, take part in the
subsequent to its commission by profiting
themselves or assisting the offender to
profit from the effects of the crime.
Criminal Actions
Misdemeanor
Felony
Criminal negligence
Reckless imprudence when a person
does an act or fails to do it voluntarily but
without malice, from which material
damage results immediately.
Simple imprudence means that the person
or nurse did not use precaution and
damage was not immediate or the
impending danger was not evident or
manifest.
Criminal intent
LEGAL BASES OF
NURSING EDUCATORS,
NURSING REGULATION
AND NURSING PRACTICE
R.A. 9173
AN ACT PROVIDING FOR A MORE
RESPONSIVE NURSING PROFESSION,
REPEALING FOR THE PURPOSE
REPUBLIC ACT NO. 7164, OTHERWISE
KNOWN AS "THE PHILIPPINE NURSING
ACT OF 1991" AND FOR OTHER
PURPOSES
Nursing
education
NURSING EDUCATION
R.A. 7164
Required a certification by the school that the
applicant belong to the upper 40% of the
graduating class, as a general requirement to
the nursing degree course.
R.A. 9173
> deletion of said admission requirement
> one high school performance is not an
accurate basis for college admission and
students mental competence and
psychological preparedness for college
education.
> More nursing students because more
graduating students will be eligible to enroll in
nursing degree program and more nursing
schools will be opened and offer the degree of
BSN.
CMO No. 30
The authorization to open a nursing school
shall be based upon:
1. written recommendation of BON,
PRC and NSA (National Student
Affiliation), DOH
2. approval of CHED
The power of BON as to authorization of
opening or closing nursing schools is
recommendatory pursuant to COM No. 30
and RA 9173.
R.A. 10609
AN ACT PROTECTING THE RIGHT OF
STUDENTS ENROLLED IN COURSES
REQUIRING PROFESSIONAL
LICENSING EXAMINATIONS TO
ENROLL IN REVIEW CENTERS OF
THEIR CHOICE AND PROVIDING
PENALTIES FOR VIOLATIONS
THEREOF.
NURSING REGULATION
NURSING REGULATION
Professional Regulatory Board of Nursing
* created under new nursing law (RA
9173)
* Primary agency responsible for the
regulation of the admission, registration
and practice of nursing profession in the
Philippines.
* Composition of BON
* one Chairperson
* Six Members
* Appointed by the President of
the Philippines
Qualification of Chairperson
and Members of BON
Representative of 3 areas of nursing
(education, service and community health
nursing)
Natural born citizen and resident of the
Philippines.
Member of good standing accredited
professional organization of nurses.
Registered nurses and holder of Masters
Degree
10 years of continuous practice of the
profession prior to appointment
No conviction of any offense involving
sound turpitude.