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
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
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
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
 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 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
 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!