This document discusses nursing practice and the law. It covers legal topics like the different types of laws, standards of practice, informed consent, negligence, and disciplinary action by boards of nursing. Key points include that nurses must follow their state's Nurse Practice Act, understand standards of care, and properly document all care to avoid legal issues like malpractice suits that commonly arise from issues like medication errors, failure to assess or report changes, and unprofessional conduct.
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Meaning of Law
Statutory law
Common law
Administrative law
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Sources of Law
The Constitution
Statutes
Administrative
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Types of Law
Criminal law
Civil law
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Criminal Law
Criminal acts are considered offenses
against the state
Three categories of criminal law
Felony
Misdemeanor
Juvenile
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Civil Law
Usually involve the violation of one
person’s rights against another’s rights
Tort
Quasi-intentional tort
Negligence
Malpractice
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Other Laws Relevant to
Nursing
Good Samaritan laws
Confidentiality
Slander and libel
False imprisonment
Assault and battery
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Nursing Standards
Established as guidelines for the profession
to ensure quality of care
Also used as criteria to determine whether
appropriate care has been delivered
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Types of Standards
Internal standards
Organizational standards
Accepted state and national standards
Nurse Practice Acts
Patient Care Partnership
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Internal Standards
Developed by institutions
Institutional policies
Maintained in policy and procedure
manuals
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Boards of Nursing
Develop the Nurse Practice Acts along with
state legislatures
The courts have upheld the authority of the
boards of nursing to regulate standards
With the expanded role of nursing, it is
important to clarify the distinction between
nursing and medicine
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Uses of Standards in Nursing
Negligence or Malpractice
Standards are used as a guide
State, local, or national standards
Institutional policies that alter or adhere to the
nursing standards of care
Expert opinions on appropriate standards of care
Available literature substantiating current
standards
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Informed Consent
Without informed consent many medical
procedures could be considered battery
Consent to treatment by the client gives the
health-care personnel the right to deliver
care without fear of prosecution
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Informed Consent
The physician obtains the consent
Gives the client the information
States the risks and advantages
The nurse may be involved in the process
by gaining signatures on the appropriate
forms
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Helpful Hints
A mentally competent adult has voluntarily
given consent
The client understands exactly what he or
she is consenting to
The consent includes the risks, alternative
treatments, and outcomes
The consent is written
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Prevention
Keep yourself informed about new
information related to your area of practice
Insist that the health-care institution keep
personnel informed of all changes in
policies and procedures and in the
management of new technological
advances
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Prevention
Always follow the standards of care or
practice for your institution
Delegate tasks and procedures to
appropriate personnel
Identify clients at risk for problems such as
falls or the development of decubiti
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Prevention
Establish and maintain a safe environment
Document precisely and carefully
Write detailed incident reports
File incident reports with appropriate
personnel and departments
Recognize client behaviors that may cause
problems
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COMMON CAUSES OF
NEGLIGENCE
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Common Causes of
Negligence
Client falls
Equipment injuries
Failure to monitor
Failure to communicate
Medication errors
Medical errors
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Medication Errors
Right drug
Right dose
Right route
Right time
Right client
Right documentation
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Tips for Credible
Documentation
Contemporaneous
Accurate
Truthful
Appropriate
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COMMON ACTIONS
LEADING TO
MALPRACTICE SUITS
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The 6 Fs
Failure to appropriately assess a client
Failure to report changes in client status
Failure to document in the client record
Failure to obtain informed consent
Failure to report a coworker’s negligence
Failure to provide adequate education
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The 2 Big Bad Ones
Altering or falsifying a record
Violation of an internal or external standard
of practice
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If a Problem Arises
When served with a complaint,
immediately contact legal counsel
Never sign any documents without
legal counsel
Notify your malpractice carrier if
covered; notify your institution
immediately
Keep all correspondence: written
and verbal
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End-of-Life Decisions
DNR orders
Advance directives
The “living will”
Durable power of attorney
Health-care surrogate
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Mandatory Overtime
Increased demand due to nursing
shortages
Physical and mental fatigue
Increased physical and emotional stress
Decreased concentration
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Licensure
In the United States, granted through the
state government via state boards of
nursing (NCLEX-RN)
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Qualifications for Licensure
Graduation from an approved nursing
program
English proficiency
Disclosure of criminal conviction
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NCLEX-RN Examination
Computerized Adaptive Testing (CAT)
Minimum and maximum number of
questions
Regulated length of time to complete the
examination
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NCLEX-RN Examination
Based on client needs and the nursing
process
Multiple choice and alternative item formats
Fill in the blank
Drag and drop
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Preparing for the NCLEX-RN
Review courses
Review books
Videos
DVDs
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Disciplinary Action
State boards of nursing
Major Issues:
Falsifying documents
Felony
Drugs or alcohol
Functioning outside the scope of practice
Abuse
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Conclusion
Nurses need to be aware of the Nurse
Practice Act in their states
Nurses need to familiarize themselves with
their institutions’ standards of care
Nurses need to understand the most
common causes of negligence
Nurses need to document accurately and
appropriately