Legal Liabilitis in Nursing

8/10/2019 Legal Liabilitis in Nursing

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LEGAL LIABILITIES INNURSING PRACTICE



NEGLIGENCE



Definition

It refers to the commission or omission ofan act, pursuant to a duty, that a

reasonably prudent person in the same orsimilar circumstances would or would notdo, and acting or the non-acting of whichis the proximate cause of injury to anotherperson or his property.



Civil Code, Article 19

One shall act with justice, give every manhis due, observe honesty and good faith.



Civil Code, Article 20

Those who, in the performance of theirobligations through negligence cause any

injury to another, are liable for damages.



Common Acts of Negligence

Burns

Objects left inside the patient’s body

Falls of elderly Falls of children

Failure to observe and take appropriate

action as needed



Specific Examples

Failure to report observations to attendingphysicians

Failure to exercise the degree of diligencewhich the circumstances of the particularcase demands

Mistaken identity Wrong medicine, wrong concentration,

wrong route, wrong dose



Conditions for Res ipsa

loquitor

That the injury was of such nature that itwould normally occur unless there was anegligent act on the part of someone

That the injury was caused by an agencywithin control of the defendant

That the plaintiff himself did not engage inany manner that would tend to bring aboutthe injury



MALPRACTICE



Definition

Implies the idea of improper or unskillfulcare of a patient by a nurse

Denotes stepping beyond one’s authoritywith serious consequences

Is a term for negligence or carelessness of

professional personnel Refers to a negligent act committed in the

course of professional performance (1962)



MEDICAL ORDERS,DRUGS,ANDMEDICATIONS.





RA 5921 (PHARMACY ACT)

All prescriptions must contain the followinginformation:

Name of the prescriber

Office address

professional registration number

Professional tax receipt number

Patient’s/client’s name, age , sex

Date of prescription.



RA 6675

Requires that the drug be written in theirgeneric names.

Only when these orders are legal writing and bearthe doctor’s signature thus the nurse have thelegal right to follow them

The nurse must not execute an order if she isreasonably certain it will result in harm to thepatient.



INTRAVENOUS THERAPY AND

LEGAL IMPLICATIONS

Philippine nursing act of 1991 section 28

“ in the administration of intravenous injections,special training shall be required according to

protocol established”.

Basis of nurses legal right to give IV injection.

Board of nursing resolution no. 8 states that any

registered nurse without such training and whoadministers IV injections to patients should beheld liable, either criminally or administratively orboth.



TELEPHONE ORDERS

Only in an extreme emergency and when noother resident or intern is available should anurse receive telephone orders.

The nurse should read back such order to thephysician to make certain the order has beencorrectly written.

Such order should be sign by the physician onhis next visit within 24 hours.



MEDICAL RECORDS

Supplies rich material for medical and nursingresearch

Serves as a legal protection for the hospital,doctor, and nurse by reflecting the disease orcondition of the patient and hismanagement.

“if it was not charted, it was not observed ordone”.



CONTINUATION..

Nurses are expected to record fully,accurately, legibly and promptly theirobservations from admission to the time ofthe patient’s discharge.

Nurses are legally and ethically bound toprotect the patient’s chart from unauthorized

person.



CHARTING DONE BY STUDENT

NURSES

When a nurse or clinical instructor countersigns the charting of the nursing student,he/she has personal knowledge ofinformation and that such is accurate andauthentic.

Anyone who countersigns without

verification commits herself to possible legalrisks.



Liabilities of nurses for

the work of nursing aides

Nurses should not delegate their functions to

nursing aides since the Philippine nursing act

specifies the scope of nursing practice of

professional nurses.

Nurses are enjoined to supervise their

subordinates and see to it that they perform only

those which they been taught to do and thosewhich they are capable of doing.



Nursing aids are responsible for their

actions.

Nurses should not delegate their

functions to nursing aides. Nursing aides perform selected nursing

activities under the direct supervision

of nurses.



LIABILITY FOR THE WORK OF

NURSING STUDENTS

RA 9173 – nursing students do not performprofessional nursing duties.

Nursing students should be under supervisionof their clinical instructors.

In order that the errors committed by nursingstudents will be avoided or minimized, the

following measures should be taken:

Nursing students should always be undersupervision of their clinical instructors.



They should be given assignments that aretheir level of training experience and

competency. They should be advised to seek guidance if

they are performing a procedure for thefirst time.

They should be oriented to the policieswhere they are assigned.

Their performance should be assessed

frequently to determine their strength andweaknesses.



TORT



Definition

A tort is a legal wrong, committed againsta person or property independent of a

contract which renders the person whocommits it liable for damages in a civilaction.



Examples

Assault and Battery.

Assault is the imminent threat of a harmful oroffensive bodily contact.

Battery is an intentional, unconsented touchingof another person.

False Imprisonment or Illegal Detention.

It means that the unjustifiable detention of aperson without legal warrant within boundariesfixed by the defendant by an act or violation ofduty intended to result in such confinement.



Defamation.

Slander is oral defamation of a

person by speaking unprivileged orfalse words by which his reputation isdamaged.

Libel is defamation by written words,cartoons or such representations thatcause a person to be avoided,ridiculed, or held in contempt or totend to injure him in his work



CRIMES



Crime defined

It is an act committed or omitted inviolation of the law. It is composed of two

elements: (1) criminal act and (2)evil/criminal intent



Conspiracy to commit a crime

A conspiracy to commit a crime existswhen two or more persons agree to

commit a felony and decide to do it.



Criminal Liability

nurse may incur criminal liability or subjectherself to criminal prosecution either bycommitting a felony or by performing an actwhich would be an offense against person orproperty.



Ignorance of the law is not an excuse

for failure to comply therewith. Violators of the criminal law cannot

escape punishment on the ground of

ignorance of the law

Ci t ff ti



Circumstances affecting

criminal liability

Justifying circumstances

Exempting circumstances

- an imbecile or insane person, unless thelatter has acted during a lucid interval.

-below 9 years old

-over 9 years of age and under fifteenunless he/she acted with discernment



- causes an injury which is merely an

accident without fault or intention or causingit

-acts under the compulsion of an

irresistible force-acts under the impulse of an

uncontrollable fear of an equal or greaterinjury



Mitigating circumstances

Are those which do not constitute justification or excuse of theoffense in question, but which in

fairness and mercy, may beconsidered as extenuating degreeof moral culpability.



Aggravating circumstances

Are those attending the commission of

crime and which increase the criminalliability of the offender or make his guiltor more severe.

Some of the ff circumstances: When the offender takes advantages of his

public position.

When the crime is commited in place of

worship When the act is committed with evident

premeditation or after an unlawful entry.



Alternative circumstances

-are those which must be taken into

consideration as aggravating or mitigatingaccording to the nature and effects of thecrime and other conditions attending in

commission.

Should be taken consideration when theoffended party is the spouse, ascendant ordescendant, legitimate, natural or adopted orrelatives.

Points in order to avoid



Points in order to avoid

criminal liability:

1. Be very familiar with the Philippine nursinglaw.

2. Beware of laws that affecting nursingpractice

3. At the start of employment, get a copy ofyour job description, the agency’s rules,

regulations and policies.

4. Upgrade you skills and competence



5. Accept only such responsibility that is within

the scope of your employment and your jobdescription.

6. Do not delegate your responsibilities toothers.

7. Determine whether your subordinates arecompetent in the work you are assigningthem.

8. Develop good interpersonal relationshipswith your co-workers, whether they be yoursupervisors, peers or subordinates.



9. Consult your superior for problems thatmaybe too big for you to handle.

10. Verify orders that are not clear to you orthose that seem to be erroneous.

11. The doctors should be informed about the

patients conditions

12. Keep in mind the values and necessity ofkeeping accurate and adequate records

13. Patients are entitled to an informedconsent.

Examples liabilities of



Examples liabilities of

Nursing:

Liability for injury to patient Liability for sponge left in the patient’s

abdomen

Liability for a safety pin left in patient’sabdomen

Liability for defective equipment

Liability for death for patient who jump fromwindow of his room



Liability for negligence of surgical nurse

Liability for rapture of surgical wound.

Liability for burns for suffered bypatient

Liability for burns from hot water bags

Liability for negligence of nurseemployees

Liability fro death of infant resulting

from injection of digitalis Liability of nurse performing

administrative work



Principals

Are those who take a direct part in theexecution of the act; who directly force orinduce others to commit; or who cooperate in

the commission of the offense by another actwithout which it would not have beenaccomplished.



Accomplices

Are those persons who, not being principals,cooperate in the execution in the offense byprevious or simultaneous act.



Accessories

Are those who, having knowledge of thecommission of the crime, either as principalsor accomplices, take part in the subsequent

to its commission by profiting themselves orassisting the offender to profit from theeffects of the crime.



Criminal Actions

Deal with acts or offenses against

public welfare.



Misdemeanor

Is a general name for a criminaloffense which does not in law amount

to felony.



Felony

Is a public offense for which aconvicted person is liable to be

sentenced to death or to beimprisoned in a penitentiary or prison.

Is committed with deceit and fault.



Criminal negligence

Reckless imprudence – when a person doesan act or fails to do it voluntarily but withoutmalice, from which material damage results

immediately.

Simple imprudence means that the person ornurse did not use precaution and damage was

not immediate or the impending danger wasnot evident or manifest.



Criminal intent

Is the state of mind of a person at thetime the criminal act is committed.

Two elements of deliberate intent:freedom and intelligence

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Legal Liabilitis in Nursing