Kozier & Erb's
Fundamentals of Nursing
Concepts, Process, and Practice
Eleventh Edition
Chapter 3
Legal Aspects of Nursing
↳ WHY?
4 AS NURSES WE ARE
ACCOUNTABLE FOR OUR
PROF. JUDGMENTS A ACMOUS.
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ACCOUNTABILITY HALLMARK
-
OFOUR PROFESSION.
Introduction
• Knowledge of laws needed to:
2 REASON – Ensure that the nurse's decisions and actions are consistent with current legal
WHYWE
SHOULD
E principles
– Protect the nurse from liability
BE KNOWLEGABLEWITH THE LAWS
REMEMBER:"IGNORANCETO THELAW EXCUSES NO ONE"
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General Legal Concepts
• Law
– The sum of total rules and regulations by which a society is governed
– Created by people
– Exists to regulate all persons -> T PREVENT CHAOS
RULES AND REGULARON PROMULGATED BY A
SUPREMEBEIG.
↓
CREAND NO REGULAT ALL PERSONS
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Functions of the Law in Nursing (1 of 2)
⑪ • Framework for establishing which nursing actions in the care of clients are legal
②
I
• Differentiates nurse's responsibilities from those of other health professionals
AS A NURSE
RESPONSIBILIMES
RIGHTS OF ME PAMENT
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Functions of the Law in Nursing (2 of 2)
③ • Helps establish boundaries of independent nursing action
• Assists in maintaining standard of nursing practice by making nurses accountable
④ under the law
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SAAN NANGGALING CHOW IT IS CREATDS
↑
Sources of Law (1 of 2)
I
⑪ • Constitutional Law SUPREME LAW CONSRMROn
Hisnannie
– Fundamental principles, ideals
– Highest set of laws - FOUNDANON FOR SYSTEM OFSUSRCE.
• Legislation (Statutory Law) STATUTORY
– Statutory laws are superior to local or administrative laws.
en ADMINISMARVE
SOURCE OF LAN IN PH
↳ PREDOMINANT
DECLARARON OFLAW BY COMPETENTAUMORI
DECISIONS OF COURST
-
WHICHIS THELEGISLAMDE
↳ CCOMMON LAWSS
ran
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Sources of Law (2 of 2)
• Administrative Law DOH, DSWD
->
– Agency given authority to create rules and regulations to enforce statutory laws
• Common Law
I
– Stare decisis, referred to as "following precedent"
↳ "TO STAND BY THINGS DECIDED"
DECISIONS OF COURT
"SUDIUIARY/ JUDIUAL DaSIOn"
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Types of Laws
• Public law 7 DEAIS WIN RELANOUSHIPS BETWEEN INDIVIDUALS & THEGOVEMENT
– Criminal law 3 bAALS WIN ACIOUS AGAINST SAFEH & WHAAREOF PUBLIC.
• Private (civil) law >PEAIS W/ RECARONSHIPS AMONG PRIVAT ( MURDER/MANSLAUGHTER
INDIVIDUALS
– Contract law HOMICIDE -
KILLING
– Tort law
-
CONTRACT - "AGREMENT"
CARGONITEINTO:
-> ENFORCES DURS 6 RIGHTS AMONG PRIVARINDIVIDUAL
NRI
AGEMENT.
1.
↓ NOT BASED ON CONTRACMAL
↑Xi NEGLIGENCE
MAIPRACRCE
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Informed Consent (1 of 8)
• Agreement by client to accept a course of treatment or procedure after being provided
complete information, including the benefits and risks of the treatment, alternatives to
the treatment, and prognosis if not treated by a healthcare provider
• Shared medical decision making
– Primary healthcare provider gives client relevant information for all treatment
alternative
– Client provides personal information that might make one treatment or therapy
more appropriate
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· AUTONOMY
-
SELF DETERMINATION/FREEDOM TO CHOOSE ONE'S DECISION.
? IF THEPARENT REFUSI N MAKEDECISION?
WHATWILL YOU DO
CAN YOU STIL DO SOMEHING?
PRIORITY: DOCUMENT - HAILMARK OFUSG ACCOUNTABILITY
0 INFORMED CONSENT > FREE A RATIONAL ACTMAT PRESUPPOSES THE
KNOWLEDGE OFPROCIDURE.
0 WAIVER 0 CONSENT
> AYAW > GO LIFPT ADHIRE'S TO A TX)
AS A
* NURSEITIS not
WHO GIVES THECOUStRT?
YOUR RESPONSIBILITYTO
LET MEPT SIGN AWAIVER, WHO EXPLAIN/ OBTAIN?
ITIS THE PHYSICIAN'S .
r
EXPLAI:1. CONDIRON OF PT
2. IST LINE OFTX
3. ALTARNARUS
4. RISK & BANIFITS
5. COMPLICANON IF IEFT UNTREATED
6. WHAT AT MAY FEEL DURING A AFTER PROCEDURE
I PAMENT DICISION -
·IFTHENURSE DECIDES IN BEHALFOF THE PI? I
0 FIEMINTS OF
INFORMED CONSENT:
VOLUNTARY(NOT FORCEDS
INFORMED - FULLY UNDERSTOOD
COMPETENCE:CRITERIA: A. LEGAL AGE
B. COHFRENT/SOUND MIND
SIGNATURE
is
-
PARACIPANT
WITNESS W
1. PARENT
↓
2. SPOUSE
↓
3. CHILDREN LLIGAL
AGES
-
4. GRAND PARENTS
↓
5. SIBLINGS
↓
6. NARIST KIN
↓
7. HOSPITAL DIRECTOR
INFORMED CONSINT:
PHYSICIAN NURSE (WITNESSS
>EXPLAIN > VERIFY IF PT UNDERSTAND THE INFORMARON
> OBTAIN X ANSWER QUESTON
~ REIFORCEINFORMARON
>Witness:1. ACMAL CONVERSARON
2. FULL IXPLANATION BY THEMD.
3. IFPT FULLYUNDERSTANDS
4. IFPT VOLUNTARILYCONSENT.
CONSENT HAS TWO CIS TYPES:
↓ ↓
EXPRISSED IMPLIED CONSENT
> EITHER ORAL/WRITTEN >FOR EMERGENCY
> IFINDIVIDUAL'S NOUVERBAL BEHAVIOR
INDICATS AGREEMENT.
Informed Consent (2 of 8)
• Express consent
– Oral or written agreement
• Implied consent
– Individual's nonverbal behavior indicates agreement.
– Medical emergency when a person cannot express content because of physical
condition
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Informed Consent (3 of 8)
• Essential elements VIOS
– Consent must be given voluntarily.
– Consent must be given by client or individual with capacity to understand.
– Must be given enough information to be the ultimate decision maker
– Client must not feel coerced.
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Informed Consent (6 of 8)
• Exceptions
– Except in specific circumstances, the following individuals cannot provide
informed consent:
▪ A minor, person 18 years or younger
▪ The unconscious or person injured in such as way that they are unable to
consent
▪ A mentally ill person judged by professionals to be incompetent
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Informed Consent (7 of 8)
• Exceptions
– Except in specific circumstances, the following individuals cannot provide
informed consent:
▪ Parent, legal guardian, or representative provides or refuses consent for
these individuals.
– Important to consider the problem of illiteracy and other language barriers
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Informed Consent (8 of 8)
• Nurse's role
– Client gave consent voluntarily.
– Signature is authentic.
– Client appears competent to give consent.
– Client has right to refuse even after signing consent form.
– Documentation important aspect
4 HALLMARK OFNSG ACCOUNTABILITY
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Delegation
• The process for a nurse to direct another person to perform nursing tasks and activities
(NCSBN)
• Nurse must know scope of practice of UAP
– Whether UAP competent to perform task
• Five rights of delegation > R. TASK
CIRCUMSTANCES
PERSON
DIRECRON/ COMMUNICATION
SUPERVISION/ IVALUATION
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RN 7 X TLACHIMG
ASSESSMENT
EVALUARON/EMERGENC
Violence, Abuse, and Neglect
I PENE
• Includes domestic violence, child abuse, abuse of older adults, and sexual abuse
• Nurses are mandated reporters.
– Required by law to report suspected abuse, neglect, or exploitation
– Detect cases at an early stage, protect children, and facilitate provision of
services
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Areas of Potential Liability in Nursing
PUNISHABLBt
• Crime ACT/OMISSIONS IN VIOCARON OFALAN MAT IS
I
– Felony, manslaughter, misdemeanor
IMPRISONMENTFIE
• Tort -> CIVIL WRONG WRONGEUL ACT COMMITED BY APERSON
– Unintentional or intentional
1 AR IMPRISONMENT.
2 IPS:A.FICONY-SERIOUS In NATUREPUNISHABL BY
DOLO-COMMITED ARU DECEI (INTT)
LACK OF
CULPA.COMMITTED BY FAULT DIT IMPRUDENCE, NGLIGENCE,
SKILL.
B. MISDEMEANOR - O IN PH
LISS SERIOUS, SHORT FRM SAIL, FIRE, BON
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Crimes and Torts (1 of 12)
• Crime
– An act committed in violation of public (criminal) law
– Punishable by a fine or imprisonment
– Does not have to be intended in order to be a crime
▪ Example: Accidentally administering an additional and lethal dose of a
narcotic to relieve discomfort
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Crimes and Torts (2 of 12)
• Felony
– Serious nature (e.g., murder)
– Punishable by term in prison
– Manslaughter
▪ Second-degree murder
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Crimes and Torts (3 of 12)
• Misdemeanor
– Less serious
– Punishable by a fine or short-term jail sentence, or both
– Example: A nurse who slaps a client's face CPH -> TORT:BATTERY)
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Crimes and Torts (4 of 12)
• Tort
– Civil wrong against a person or a person's property
– Based on fault
▪ Something done incorrectly
▪ Something omitted
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Crimes and Torts (5 of 12)
• Unintentional Torts
– Negligence
▪ Misconduct or practice below standard expected of ordinary, reasonable,
prudent person
– Places another person at risk for harm
– Applies to anyone
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Crimes and Torts (6 of 12)
• Unintentional Torts
– Gross negligence
▪ Extreme lack of knowledge, decision making, or skill that should have been
known that put others at risk for harm
– Malpractice
▪ Negligence that occurs while the person is performing as a professional
▪ Applies to physicians, dentists, lawyers, and generally includes nurses
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Crimes and Torts (7 of 12)
• Unintentional Torts
– Malpractice
▪ Elements present to prove malpractice
– Duty
– Breach of duty
– Foreseeability
– Causation
– Harm or injury
– Damages
HE THING SPEAKS FOR ITSELF
▪ Res ipsa loquitur ->
EVIDENCE SPAKS FOR ITSILE
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Crimes and Torts (8 of 12)
• Unintentional Torts
– Malpractice
▪ Measures to prevent malpractice
– Check and recheck medications
• Medication error
– Check side rails before leaving a client
• Client safety
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Crimes and Torts (9 of 12)
• Unintentional Torts
– Malpractice
▪ Measures to prevent malpractice
– Do not ignore a client's complaint
• Failure to observe and take appropriate action
– Right client
• Mistaken identity
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Crimes and Torts (10 of 12)
• Intentional Torts
– Assault
▪ Attempt or threat to touch another person unjustifiably
– Battery
▪ Willful touching of person (including clothes or something carried) that may
or may not cause harm
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Crimes and Torts (11 of 12)
• Intentional Torts
– False imprisonment -> LIMITARON OF MOVEMENT
▪ Unjustifiable detention of a person without legal warrant to confine the
person EX: USEOF RISTRAITS, ALL SIDE RAILS UP
– Invasion of privacy
▪ Direct wrong of a personal nature
▪ Unnecessary discussions, gossip
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Crimes and Torts (12 of 12)
• Intentional Torts
– Defamation -> PANINIRANG PURS
▪ Communications that are false
- PUBLIC
▪ Libel ISULAT AT PAPELS
E??? E – Defamation by means of print, writing, or pictures
CILANGS
▪ Slander CPRIVATES
– Defamation by spoken word
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