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REGULATORY BODIES AND LEGAL ASPECTS IN NURSING
JENITA JOYCE JOHNI YEAR MSc (N)APOLLO COLLEGE OF NURSING
INTRODUCTION Regulatory agencies are usually a part
of the executive branch of the government, or they have statutory authority to perform their functions with oversight from the legislative branch. Their actions are generally open to legal review. Regulatory authorities are commonly set up to enforce standards and safety
REGULATORY BODIES A regulatory body
is a public authority or government agency responsible for exercising autonomous authority over some area of human activity in a regulatory or supervisory capacity.
INTERNATIONAL AGENCIES INTERNATIONAL COUNCIL OF NURSES
(ICN) AMERICAN NURSES ASSOCIATION (ANA) CANADIAN NURSES ASSOCIATION (CNA) AUSTRALIAN NURSES AND MIDWIVES
ASSOCIATION BRITISH NURSES ASSOCIATION
INDIAN REGULATORY AGENCIES INDIAN NURSING COUNCIL TRAINED NURSING ASSOCIATION OF
INDIA (TNAI) STATE NURSING COUNCIL STATE MEDICAL HEALTH UNIVERSITIES
INTERNATIONAL COUNCIL OF NURSES Founded in 1899,
headquartered in Geneva, Switzerland
World’s first largest international organization for health
Represents 16 million international nurses
130 national nurses organization
The Three goals are: To bring nursing together worldwide To advance nurses and nursing worldwide To influence health policy.Core Values: Visionary Leadership Inclusiveness Flexibility Partnership Achievement
OBJECTIVES
QUALITY NURSING CARE FOR
ALL
SOUND HEALTH
POLICIES
COMPETENT & SATISFIED
WORKFORCEADVANCEMENT
OF NURSING KNOWLEDGE
BOARD OF DIRECTORS ICN governed by 16 member board of
directors Board meets every year
JUDITH SHAMIAN
• President
DAVID C BENTON
• CEO
PUBLICATIONS International Nursing Review Health and Well being of Women Incentive for health professionals
AMERICAN NURSES ASSOCIATION Founded in 1896,
based in Silver Spring, Maryland, USA
Represents RNs of USA Professional
organization to advance and protect nursing profession
Functions:• Policy development• Organizations partnership• Publications and Newsletters > The American Nurse > American Nurse Today
INDIAN NURSING COUNCIL (INC)AIM – To establish a uniform standard of training for nurses midwives and health visitors INC is a regulatory body for
nurses and nursing education in India
It is an autonomous body under the Government of India, Ministry of Health and Family Affairs
ORGANIZATIONAL STRUCTUREPRESIDENT
VICE PRESIDENT
SECRETARY
JOINT SECRETARY
DEPUTY SECRETARY
ASSIATANT SECRETARY
OFFICE STAFF
COMMITTEESEXECUTIVE
NURSING EDUCATION
EQUIVALENCE
FINANCE VIGILANCE
ANTI RAGGING
DEPARTMENTAL
PROMOTION
PURPOSESUNIFORM
STANDARDS OF EDUCATION
NURSES REGISTRATIO
N
REGISTRATION OF FOREIGN
NURSES
INDIAN NURSING REGISTER
FUNCTIONS INC FUNCTIONS
PRESCRIBE SYLLABI
IMPLEMENT SYLLABI
INSPECTION OF EXAM CENTRES
INSPECTION OF SCHOOLS AND COLLEGES OF NURSING
MAINTAIN INDIAN NURSES REGISTER
WITHDRAWL OF RECOGNITION
TRAINED NURSES ASSOCIATION OF INDIA (TNAI) Formed in 1908 at
Delhi, India It is a National body
of practitioners of nursing at various levels
It is a professional association of nurses
Affiliated to Commonwealth Nurses Federation
AIMS upgrading
UPGRADING, DEVELOPMENT AND STANDARDIZATION OF
NURSING EDUCATION
IMPROVEMENT OF LIVING AND WORKING CONDITIONS
OF NURSES IN INDIA
REGISTRATION FOR QUALIFIED NURSES
ACTIVITIES
CONFERENCES CNE
PUBLICATIONS
NURSING REGULATION
S
SCHOLARSHIP
FUNCTIONS OF THE TNAI Nurses Charter Standardization of Nursing Education Service Condition for Nurses Continuing Education Programme Socio – Economic Welfare programmes Scholarships Nurse’s welfare Funds Relationship with the Government International Affiliations Projects
BOARD OF DIRECTORS President – Mr. A.B Kulkarni Vice President – Sr. (Prof) Gilbert Secretary General – Mrs. Sheila Seda
PUBLICATIONS
CHN MANUAL
NURSING JOURNAL OF INDIA
HANDBOOK OF TNAI
MEMBERSHIP Membership is
obtained by submission of a copy of own state registration certificate
Membership can also be transferred by SNA to TNAI within 6 months after course completion
STATE NURSING COUNCIL Maintains register of names of
professional nurses of their state These names are also maintained in
the Indian Nurses Register by INC
FUNCTIONS
RECOGNITION OF SCHOOLS
AND COLLEGES
CONDUCT EXAMINATI
ONS
PRESCRIBE RULES
MAINTAIN REGISTERS
TAMIL NADU NURSES AND MIDWIVES COUNCIL
Registering body for nurses, midwives, ANM, MPHW, health visitors as per INC standards
Extends registration to union territories – Pondicherry, Andaman & Nicobar Islands
BOARD OF DIRECTORS
Dr. A. Chandranathan
• President
Prof. Dr. Ani Grace
• Registrar
THE TAMIL NADU DR MGR MEDICAL UNIVERSITY
Known as The Tamil Nadu Medical University in 1980
1988 – The Tamil Nadu Dr MGR Medical University
Deals with Medicine, Dentistry, Indian Medicine/Homeopathy and Allied Health Sciences
OBJECTIVESORGANIZE ADVANCED STUDIES
INSTITUDE DEGREES, DIPLOMAS & OTHER ACADEMIC DISTINCTIONS
SCHOLARSHIPS, MEDALS, PRIZES
DEVELOP RESEARCH FACILITIES
ORGANIZE STUDY PROGRAMS
BOARD OF DIRECTORS
Dr. K. Rosaiah
• Chancellor
Dr. D. Shantharam
• Vice Chancellor
LEGAL ASPECTS IN NURSING
INTRODUCTION
It is important for nurses to know the basic legal concepts because nurses are accountable for their professional judgments and actions
NURSING LAW Defined as that body of status, executive orders, regulations, rule and legal precedents which have their objective the promotion and protection of individual and community by nursing service
FUNCTIONS
FRAMEWORK FOR NURSING ACTIONDIFFERENTIATES NURSES RESPONSIBILITYBOUNDARIES INDEPENDENT NURSING ACTIONSMAINTAIN STANDARD PRACTICE
SOURCES OF LAW
CONSTITUTIONAL LAW
COMMON LAW
ADMINISTRATIVE LAW
TYPES OF LAW
PUBLIC LAWPRIVATE LAWCRIMINAL LAW
VOLENTI – NON – FIT - INJURIA French, it means
Voluntarily – suffered – injury
It is a law that no man can sue for a tort to which he had consented either expressly or impliedly
PATIENT’S RIGHTS
LEGAL SAFEGUARDS IN NURSING PRACTICE Licensure Good Samaritan Law Good rapport Standards of care Standing orders Informed consent Correct identity Documentation Reporting
LEGAL RESPONSIBILITIES OF A NURSE Appointing and assigning Quality control Equipment Observation and reporting Record keeping and recording Death and dying
MEDICO LEGAL ASPECTS OF DEATH Be with patient during
death Reassure patient’s
relatives Do not whisper Only doctors declare death Death records Respect body and conduct
all last offices Take signature of party
before releasing the body
INDIAN PENAL CODE AND MEDICAL PRACTICE The patient or guardian
can only claim damages from doctor and hospitals
Both parties bear their own legal expenses
Patient or guardian can get the doctor and hospital authority fined or jailed by proving negligence in court of law
TORT Tort is a civil wrong for which remedy is
common law action To constitute a tort all the following
conditions must be satisfied Omission Wrongful Act Legal Damage Legal Remedy
CLASSIFICATION OF TORT
INTENTIONAL TORT• Willful act that violate
another’s rights – AssaultUNINTENTIONAL TORT• Includes negligence or
malpractice
Types of Law
Private/CivilContract
Law TortIntentio
nalAssault/Battery
False Imprisonment
Invasion of
PrivacyDefamat
ionLibe
lSland
er
Willful ActionIntended
consequences
Causation
Unintentional
Negligence/Malpractice
Failure to meet
standard of care
Duty,Breach of
duty,Forseeability,Causation,Injury/harm,damag
e
Public
Criminal Law
Felony
Misdemeanor
Felony – A serious crime Tort – Civil wrong for which remedy is a
common law action Assault – Any willful attempt or threat
or harm another with ability to actually harm the person
Battery – Intentional touching of another’s body or anything without consent
Legal – Connected with the law
Plantiff – Person who has lodged the complaint
Malpractice – Professional misconduct Malice – Desire to harm someone Slander – Act or crime of making a false
statement damaging to a person’s reputation Negligence – Carelessness which caused
negative results Fidelity – Quality of being faithful/loyal Defendant – A person accused of crime Breach of duty – There must be a standard of
care but the nurse did not observe
Foreseeability- A link must exist between the nurses’ act and the injury suffered
Causation – It must be proved that the harm occurred as a direct result of the nurses’ failure to follow the standard of care the nurse should have
Harm/Injury – The client must demonstrate some type of harm or injury physical, financial or emotional) as a result of the breach of duty owed the client
Damages – If malpractice causes injury the nurse is liable foe damage
Manslaughter – second degree murder Misdemeanor – Offence of a less
serious nature and usually punishable by fine
LEGAL ASPECTS Informed consent Delegation Violence, abuse and neglect Controlled substances The impaired nurse Sexual harassment Abortions Death and related issues
INFORMED CONSENTIt is an agreement by a client to accept a course of treatment or a procedure after being provided complete information including the benefits and risks of treatment.
TYPES
EXPRESS
IMPLIFIED
DELEGATIONTransfer of responsibility for the performance of an activity from one person to another while retaining accountability for the same
VIOLENCE, ABUSE AND NEGLECT When an identified instance of injury
appears to be present as the result of abuse, neglect or exploitation the nurse must report it to the authorities
CONTROLLED SUBSTANCESThe laws regulate the distribution of controlled substances such as narcotics, depressants, stimulants and hallucinogens
THE IMPAIRED NURSERefers to a nurse whose ability to perform the functions of a nurse is diminished by chemical dependency on drugs, alcohol or mental illness
SEXUAL HARASSMENTUnwelcome sexual advances, request for favors and other verbal or physical conductNurses must develop skills of assertiveness to deter harassment in the work place
ABORTIONS The nurses have the right to refuse
participation in abortions Nurse can assist abortions under MTP
act
DEATH AND RELATED ISSUES Autopsy Certification of death Do Not Resuscitate orders Euthanasia Inquest Organ donation
LEGAL ISSUES IN SPECIALTY PRACTICE AREAS
MEDICAL SURGICAL NURSING CHILD HEALTH NURSING MATERNAL AND NEW BORN NURSING PSYCHIATRY NURSING
MEDICAL SURGICAL NURSING Disoriented adults may require some
form of restraints to prevent accidental self injury
Side rails are available on most hospital beds
Disoriented older patients may require belt restraints to prevent them falling off the bed
If patient falls off the bed they may sue the nurse and hospital
COMMON ACT OF NEGLIGENCE IN MEDICAL SURGICAL NURSING
Overlooked sponges, needles and instruments Burns Falls Injury due to use of defective apparatus or
supplies Loss or damage Assault and battery Failure to report accidents Maintenance of records and reports
COMMON ACT OF NEGLIGENCE IN CHILD HEALTH NURSING
Pediatric nurses are responsible for preventing children in their care from accidently harming themselves
Cribs with restraints are designed to keep infants and toddlers from climbing out of bed
Poisonous substances and sharps should be kept out of reach of children
Suspected child abuse or neglect must be reported
COMMON ACT OF NEGLIGENCE IN OBG NURSING
Causes of lawsuit for malpractice in this area can be divided into 2 – Mother and Child
Lawsuits brought against physicians and nurses differ
LIKELY AGAINST DOCTORS… Failure to diagnose a high risk
pregnancy Delay in performing a Caesarean
section Improper vaginal delivery or failure to
perform a C section Improper use of forceps Delay in arriving to hospital Non attendance at the delivery
LIKELY AGAINST NURSES… Problems of medication Failure in adequate client monitoring Failure to adequately assess the client Failure to report changes in the client Abortions Nursing care of new born
COMMON ACT OF NEGLIGENCE IN PSYCHIATRY NURSING
CRITERIA Dangerous to others Dangerous to self Need for treatment
Immediate restraint of the insane Voluntary admission Admission through magistrate Admission through police power Reception after judicial inquisition Discharge Discharge on parole Abscond of the patient
CONCLUSION
JOURNAL INFORMATIONMenendez Juliet Battard, “Informed Consent”, JONA healthcare, Laws, Ethics and Regulation, Volume 15, Number 4, Oct – Dec 2013
THANK YOU