Legal Implications in Nursing Practice

MOHAMMED ALHABSI INDANANMOHAMMED ALHABSI INDANANClinical InstructorKing Abdul Aziz Specialist Hospital- TaifKingdom of Saudi Arabia

Legal Implications in Nursing Sources of law Civil & Common law in Nursing

practice Licensure Risk Management

Law“The sum total of rules & regulations by which a society is governed.

As such, law is created by people & exists to regulate all persons”

GUIDO, 2001

Functions of the Law in Nursing It provides a framework for establishing which

nursing actions in the care of clients are legal.

It differentiates the nurse’s responsibilities from those of other health professionals.

It helps establish the boundaries of independent nursing action.

It assist in maintaining a standard of nursing practice by making nurses accountable under the law.

Sources of LawSources of Law Constitutional law Legislation law (Statutory law) Administrative law Common law

Constitutional LawThe supreme law of a country.Creates legal rights &

responsibilities and a foundation of a system of justice.

Legislation law (Statutory law)Enacted by any legislative

bodyThe regulation of nursing is

a function of state law

Administrative law

It creates rules & regulations to enforce the statutory laws.

Common LawLaws evolving from court

decisions. Interpreting & applying the

constitutional or statutory law.

TYPES OF LAW

PUBLIC LAW PRIVATE LAW

CRIMINAL LAW CONTRACT LAW TORT LAW

Criminal Law

Felony Misdemeanor

Categories of

Civil Law

Intentional Tort

AssaultBattery

False Imprisonment

Quasi-IntentionalTort

Invasion of PrivacyDefamation of Character

Slander & Libel

Unintentional Tort

NegligenceMalpractice

In order to prove that negligence or malpractice has occurred, circumstances must be present & must be proven in a court of law these are:

1. Harm must have occurred to the individual2. One person must be in a situation where he

had duty towards the person harmed3. The person must be found to have failed to

fulfill his/her duties4. The harm must be shown to have been

caused by the breach of duty.

Liability

PersonalLiability

EmployerLiability

SupervisoryLiability

Licensure

Licensure Is a legal permit that a government

agency grants to individuals to engage in the practice of a profession & to use a particular title.

Nursing Licensure is mandatory

For a profession or occupation to obtain the right to license its members, it generally must meet 3 criteria:

1. There is a need to protect the public’s safety or welfare

2. The occupation is clearly delineated as a separate, distinct area of work.

3. There is a proper authority to assume the obligations of the licensing process e.g. board of nursing

Grounds for Revocation of license Incompetent nursing practice Professional misconduct Conviction to a crime

Risk Management

Patient Safety in Health Care“The degree to which the risk of

an intervention & risk in the care environment are reduced for a patient & other persons, including health care practitioners”

JCAHO 2003

Purposes of Risk ManagementThe department focuses on identification &

prevention of risk exposures within the organisation that could:

Cause injury to patient, visitors, & employees Jeopardize the safety & security of the

environment Result in costly claims & lawsuits with

subsequent financial loss to the organisation

2 main Areas of Risk Management1. Clinical Risk Management

e.g. medical error, sentinel event

2. Environmental Risk Management

e.g. safety, security & preventive maintenance

Patient Safety Goals:1. Improve the process of Patient

Identification2. Eliminate wrong-site, Wrong Patient &

Wrong Procedure Surgery3. Improve the effectiveness of

Communication among Caregiver4. Improve the Safety of High Alert

Medications

5. Improves Safety in Infusions Pumps

6. Improve the effectiveness of Clinical Alarm systems

7. Reduce the risk of healthcare-acquired infections

8. Accurately & completely reconcile medications across the continuum of care

9. Reduce the risk of patient harm resulting from falls

RestraintRestraint Policy Policy

RestraintsRestraints

are protective devices used to limit the physical activity of the client or part of the body.

Purpose: is to prevent the client from injuring self or others.

22 Classification ofClassification ofRestraintsRestraints

PHYSICALPHYSICAL CHEMICALCHEMICAL

Any order for Restraint & the Any order for Restraint & the Implementation of the Implementation of the Restraint order must be:Restraint order must be:

1. In accordance with a written modification to the patient plan of care.

2. Implemented in the least restrictive manner possible.

3. In accordance with safe appropriate restraining techniques.

4. Ended at the earliest possible time.5. documented.

Practice Guidelines for Restraint Application

1. Obtain a consent

2. Ensure the order is provided

3. Assess the restraint every 30 minutes

4. Release restraint at least 8 hours

5. Never leave patient unattended if restraint is removed

6. Provide emotional support

5 Criteria before Selecting Restraint

1. It restricts the client’s movement as little as possible

2. It doesn’t interfere with the client’s treatment or health problems

3. It is readily changeable

4. It is safe for the particular client

5. It the least obvious to others

Kinds of Restraints Jacket restraint Belt restraint Mitt or hand restraint Mummy restraint Elbow restraint Crib nets

OVROVR

Occurrence VarianceAny event which happens or may

happen which is not consistent with normal standard, usually in clinical practice or routine patient care, or threatens the health or life of a patient, a visitor, an employee or a student, or which involves loss or damage to personal or Hospital property.

Occurrence Variance Report Utilized as a quality tool for

Continuous Quality Improvement ONLY

NON-Punitive Not be placed in the pt’s record Should be reported as soon as

possible or within 24 hours Handled & maintained in a

confidential manner

Criteria of OVRCriteria of OVR Should be completed for any UNUSUAL,

UNEXPECTED or UNANTICIPATED Occurrences and for any event which has or may have an adverse patient outcome.. Patient falls Medication Error Loss of Valuables, belongings Equipment malfunction Property damage

Magsukul…Magsukul…….….