REGULATORY BODIES AND LEGAL
ASPECTS IN NURSING
JENITA JOYCE JOHN
I 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 auth...
REGULATORY BODIES
A regulatory body
is a public
authority or governm
ent
agency responsible
for exercising
autonomous
auth...
INTERNATIONAL AGENCIES
INTERNATIONAL COUNCIL OF NURSES
(ICN)
AMERICAN NURSES ASSOCIATION (ANA)
CANADIAN NURSES ASSOCIATION...
INDIAN REGULATORY AGENCIES
INDIAN NURSING COUNCIL
TRAINED NURSING ASSOCIATION OF
INDIA (TNAI)
STATE NURSING COUNCIL
STATE ...
INTERNATIONAL COUNCIL OF NURSES
Founded in 1899,
headquartered in Geneva,
Switzerland
World’s first largest
international ...
The Three goals are:
To bring nursing together worldwide
To advance nurses and nursing worldwide
To influence health polic...
OBJECTIVES
QUALITY
NURSING
CARE FOR
ALL
SOUND
HEALTH
POLICIES
COMPETENT &
SATISFIED
WORKFORCE
ADVANCEMENT OF
NURSING
KNOWL...
BOARD OF DIRECTORS
ICN governed by 16 member board of
directors
Board meets every year
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 orga...
Functions:
• Policy development
• Organizations partnership
• Publications and Newsletters
> The American Nurse
> American...
INDIAN NURSING COUNCIL (INC)
AIM – To establish a uniform
standard of training for nurses
midwives and health visitors
INC...
ORGANIZATIONAL STRUCTURE
COMMITTEES
PURPOSES
UNIFORM
STANDARDS OF
EDUCATION
NURSES
REGISTRATION
REGISTRATION
OF FOREIGN
NURSES
INDIAN
NURSING
REGISTER
FUNCTIONS
TRAINED NURSES ASSOCIATION OF INDIA (TNAI)
Formed in 1908 at
Delhi, India
It is a National body
of practitioners of
nursin...
AIMS
upgrading
UPGRADING, DEVELOPMENT
AND STANDARDIZATION OF
NURSING EDUCATION
IMPROVEMENT OF LIVING
AND WORKING CONDITION...
ACTIVITIES
FUNCTIONS OF THE TNAI
Nurses Charter
Standardization of Nursing Education
Service Condition for Nurses
Continuing Educatio...
BOARD OF DIRECTORS
• President – Mr. A.B Kulkarni
• Vice President – Sr. (Prof) Gilbert
• Secretary General – Mrs. Sheila ...
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
tra...
STATE NURSING COUNCIL
Maintains register of names of professional
nurses of their state
These names are also maintained in...
FUNCTIONS
TAMIL NADU NURSES AND MIDWIVES COUNCIL
Registering body for
nurses, midwives,
ANM, MPHW, health
visitors as per INC
standa...
BOARD OF DIRECTORS
THE TAMIL NADU DR MGR MEDICAL UNIVERSITY
Known as The Tamil Nadu
Medical University in 1980
1988 – The Tamil Nadu Dr
MGR M...
OBJECTIVES
BOARD OF DIRECTORS
LEGAL ASPECTS IN NURSING
INTRODUCTION
It is important for nurses to know the basic legal
concepts because nurses are accountable for their
professi...
NURSING LAW
Defined as that body of
status, executive orders,
regulations, rule and legal
precedents which have their
obje...
FUNCTIONS
FRAMEWORK FOR NURSING ACTION
DIFFERENTIATES NURSES RESPONSIBILITY
BOUNDARIES INDEPENDENT NURSING ACTIONS
MAINTAI...
SOURCES OF LAW
CONSTITUTION
AL LAW
COMMON
LAW
ADMINISTRATIV
E LAW
TYPES OF LAW
VOLENTI – NON – FIT - INJURIA
French, it means Voluntarily –
suffered – injury
It is a law that no man can sue
for a tort ...
PATIENT’S RIGHTS
LEGAL SAFEGUARDS IN NURSING PRACTICE
Licensure
Good Samaritan Law
Good rapport
Standards of care
Standing orders
Informed ...
LEGAL RESPONSIBILITIES OF A NURSE
Appointing and assigning
Quality control
Equipment
Observation and reporting
Record keep...
MEDICO LEGAL ASPECTS OF DEATH
Be with patient during death
Reassure patient’s relatives
Do not whisper
Only doctors declar...
INDIAN PENAL CODE AND MEDICAL PRACTICE
The patient or guardian can
only claim damages from
doctor and hospitals
Both parti...
TORT
Tort is a civil wrong for which remedy is
common law action
To constitute a tort all the following conditions
must be...
CLASSIFICATION OF TORT
• Willful act that violate
another’s rights – Assault
• Includes negligence or
malpractice
Types of Law
Private/Civil
Contract
Law Tort
Intentiona
l
Assault/Batte
ry
False
Imprisonment
Invasion of
Privacy
Defamati...
Felony – A serious crime
Tort – Civil wrong for which remedy is a
common law action
Assault – Any willful attempt or threa...
Plantiff – Person who has lodged the complaint
Malpractice – Professional misconduct
Malice – Desire to harm someone
Sland...
Foreseeability- A link must exist between the
nurses’ act and the injury suffered
Causation – It must be proved that the h...
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 hara...
INFORMED CONSENT
It is an agreement by a client to accept a
course of treatment or a procedure after being
provided comple...
DELEGATION
Transfer of responsibility for the performance
of an activity from one person to another while
retaining accoun...
VIOLENCE, ABUSE AND NEGLECT
When an identified instance of injury appears
to be present as the result of abuse, neglect
or...
CONTROLLED SUBSTANCES
The laws regulate the distribution of controlled
substances such as narcotics, depressants,
stimulan...
THE IMPAIRED NURSE
Refers to a nurse whose ability to perform the
functions of a nurse is diminished by chemical
dependenc...
SEXUAL HARASSMENT
Unwelcome sexual advances, request for
favors and other verbal or physical conduct
Nurses must develop s...
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
PSYCH...
MEDICAL SURGICAL NURSING
Disoriented adults may require some form of
restraints to prevent accidental self injury
Side rai...
COMMON ACT OF NEGLIGENCE IN MEDICAL
SURGICAL NURSING
Overlooked sponges, needles and instruments
Burns
Falls
Injury due to...
COMMON ACT OF NEGLIGENCE IN CHILD HEALTH
NURSING
Pediatric nurses are responsible for
preventing children in their care fr...
COMMON ACT OF NEGLIGENCE IN OBG
NURSING
Causes of lawsuit for malpractice in this area
can be divided into 2 – Mother and ...
LIKELY AGAINST DOCTORS…
Failure to diagnose a high risk pregnancy
Delay in performing a Caesarean section
Improper vaginal...
LIKELY AGAINST NURSES…
Problems of medication
Failure in adequate client monitoring
Failure to adequately assess the clien...
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
Receptio...
CONCLUSION
JOURNAL INFORMATION
Menendez Juliet Battard, “Informed Consent”,
JONA healthcare, Laws, Ethics and
Regulation, Volume 15, ...
THANK YOU
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Regulatory bodies and legal aspects in nursing

  1. 1. REGULATORY BODIES AND LEGAL ASPECTS IN NURSING JENITA JOYCE JOHN I YEAR MSc (N) APOLLO COLLEGE OF NURSING
  2. 2. 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
  3. 3. REGULATORY BODIES A regulatory body is a public authority or governm ent agency responsible for exercising autonomous authority over some area of human activity in a regulatory or super visory capacity.
  4. 4. INTERNATIONAL AGENCIES INTERNATIONAL COUNCIL OF NURSES (ICN) AMERICAN NURSES ASSOCIATION (ANA) CANADIAN NURSES ASSOCIATION (CNA) AUSTRALIAN NURSES AND MIDWIVES ASSOCIATION BRITISH NURSES ASSOCIATION
  5. 5. INDIAN REGULATORY AGENCIES INDIAN NURSING COUNCIL TRAINED NURSING ASSOCIATION OF INDIA (TNAI) STATE NURSING COUNCIL STATE MEDICAL HEALTH UNIVERSITIES
  6. 6. 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
  7. 7. 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
  8. 8. OBJECTIVES QUALITY NURSING CARE FOR ALL SOUND HEALTH POLICIES COMPETENT & SATISFIED WORKFORCE ADVANCEMENT OF NURSING KNOWLEDGE
  9. 9. BOARD OF DIRECTORS ICN governed by 16 member board of directors Board meets every year
  10. 10. PUBLICATIONS International Nursing Review Health and Well being of Women Incentive for health professionals
  11. 11. AMERICAN NURSES ASSOCIATION Founded in 1896, based in Silver Spring, Maryland, USA Represents RNs of USA Professional organization to advance and protect nursing profession
  12. 12. Functions: • Policy development • Organizations partnership • Publications and Newsletters > The American Nurse > American Nurse Today
  13. 13. 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
  14. 14. ORGANIZATIONAL STRUCTURE
  15. 15. COMMITTEES
  16. 16. PURPOSES UNIFORM STANDARDS OF EDUCATION NURSES REGISTRATION REGISTRATION OF FOREIGN NURSES INDIAN NURSING REGISTER
  17. 17. FUNCTIONS
  18. 18. 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
  19. 19. AIMS upgrading UPGRADING, DEVELOPMENT AND STANDARDIZATION OF NURSING EDUCATION IMPROVEMENT OF LIVING AND WORKING CONDITIONS OF NURSES IN INDIA REGISTRATION FOR QUALIFIED NURSES
  20. 20. ACTIVITIES
  21. 21. 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
  22. 22. BOARD OF DIRECTORS • President – Mr. A.B Kulkarni • Vice President – Sr. (Prof) Gilbert • Secretary General – Mrs. Sheila Seda
  23. 23. PUBLICATIONS CHN MANUAL NURSING JOURNAL OF INDIA HANDBOOK OF TNAI
  24. 24. 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
  25. 25. 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
  26. 26. FUNCTIONS
  27. 27. 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
  28. 28. BOARD OF DIRECTORS
  29. 29. 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
  30. 30. OBJECTIVES
  31. 31. BOARD OF DIRECTORS
  32. 32. LEGAL ASPECTS IN NURSING
  33. 33. INTRODUCTION It is important for nurses to know the basic legal concepts because nurses are accountable for their professional judgments and actions
  34. 34. 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
  35. 35. FUNCTIONS FRAMEWORK FOR NURSING ACTION DIFFERENTIATES NURSES RESPONSIBILITY BOUNDARIES INDEPENDENT NURSING ACTIONS MAINTAIN STANDARD PRACTICE
  36. 36. SOURCES OF LAW CONSTITUTION AL LAW COMMON LAW ADMINISTRATIV E LAW
  37. 37. TYPES OF LAW
  38. 38. 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
  39. 39. PATIENT’S RIGHTS
  40. 40. LEGAL SAFEGUARDS IN NURSING PRACTICE Licensure Good Samaritan Law Good rapport Standards of care Standing orders Informed consent Correct identity Documentation Reporting
  41. 41. LEGAL RESPONSIBILITIES OF A NURSE Appointing and assigning Quality control Equipment Observation and reporting Record keeping and recording Death and dying
  42. 42. 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
  43. 43. 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
  44. 44. 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
  45. 45. CLASSIFICATION OF TORT • Willful act that violate another’s rights – Assault • Includes negligence or malpractice
  46. 46. Types of Law Private/Civil Contract Law Tort Intentiona l Assault/Batte ry False Imprisonment Invasion of Privacy Defamatio n Libel Slande r Willful Action Intended consequence s Causatio n Unintention al Negligence/Mal practice Failure to meet standard of care Duty,Breach of duty,Forseeabil ity,Causation,I njury/harm,da mage Public Criminal Law Felon y Misdemeano r
  47. 47. 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
  48. 48. 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
  49. 49. 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
  50. 50. Manslaughter – second degree murder Misdemeanor – Offence of a less serious nature and usually punishable by fine
  51. 51. LEGAL ASPECTS Informed consent Delegation Violence, abuse and neglect Controlled substances The impaired nurse Sexual harassment Abortions Death and related issues
  52. 52. INFORMED CONSENT It 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
  53. 53. DELEGATION Transfer of responsibility for the performance of an activity from one person to another while retaining accountability for the same
  54. 54. 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
  55. 55. CONTROLLED SUBSTANCES The laws regulate the distribution of controlled substances such as narcotics, depressants, stimulants and hallucinogens
  56. 56. THE IMPAIRED NURSE Refers to a nurse whose ability to perform the functions of a nurse is diminished by chemical dependency on drugs, alcohol or mental illness
  57. 57. SEXUAL HARASSMENT Unwelcome sexual advances, request for favors and other verbal or physical conduct Nurses must develop skills of assertiveness to deter harassment in the work place
  58. 58. ABORTIONS The nurses have the right to refuse participation in abortions Nurse can assist abortions under MTP act
  59. 59. DEATH AND RELATED ISSUES Autopsy Certification of death Do Not Resuscitate orders Euthanasia Inquest Organ donation
  60. 60. LEGAL ISSUES IN SPECIALTY PRACTICE AREAS MEDICAL SURGICAL NURSING CHILD HEALTH NURSING MATERNAL AND NEW BORN NURSING PSYCHIATRY NURSING
  61. 61. 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
  62. 62. 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
  63. 63. 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
  64. 64. 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
  65. 65. 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
  66. 66. 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
  67. 67. COMMON ACT OF NEGLIGENCE IN PSYCHIATRY NURSING CRITERIA Dangerous to others Dangerous to self Need for treatment
  68. 68. 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
  69. 69. CONCLUSION
  70. 70. JOURNAL INFORMATION Menendez Juliet Battard, “Informed Consent”, JONA healthcare, Laws, Ethics and Regulation, Volume 15, Number 4, Oct – Dec 2013
  71. 71. THANK YOU
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