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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 pt’s 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 pt’s 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 patient’s 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!
