OKK

4. The legal aspects of nursing have an impact on
the manner in which care is delivered to patients
by nurses. Legal concerns shape the environment
in which nursing is practical and determined how
documents are kept or shared. Ultimately nurses
and the nursing care they provide are judged
based on legal definition for the standard of care
for nurses.

5. “The sum total of rules and regulation by which
the society is governed. As such, law is created
by people and exist to regulate all persons.”

6. There are two types of law:
PUBLIC LAWS
 Constitutional law
 Criminal law
 Administrative law

7. PRIVATE LAW / CIVIL LAWS
 Torts
 Contract law

8. It refers to the body of law that deals with
relationship between individuals and government
and governmental agencies.
CONSTITUTIONAL LAW
Fundamental law written or unwritten that
establishes the character of government by
defining the basic principle to which a
society must conform.

9. Prevent harm to society and provides
punishment for crimes.
 ADMINISTRATIVE LAW
When a state legislature passes a statute,
an administrative agencies is given authority
to create rules and regulations to enforce the
statutory laws.

10. The body of the law that deals with the
relationship among private individuals.
 CONTRACT LAW
Legally binding exchange of promises or
agreement between parties that the law will
enforce.

11.  TORT LAW
It defines and enforce duties and rights among private
individuals that are not based on the contractual
agreement.
Tort is a legal wrong committed against a person his
or her rights or property, intentional willfully
committed without just cause.

12. UNINTENTIONAL
TORT
INTENTIONAL
TORT
QUASI-
INTENTIONAL TORT

13. Deliberate actions in which the intent is to cause
injury to a person or property.

14.  BATTERY
Purposely touching or applying force on other persons
or things related to the person without his consent with
the intention to harm the person is considered as a
battery.
It is divided into two types:
• Criminal battery- intention to kill a person
• Civil battery- no intention to kill a person

15.  ASSAULT
The assault is generally an attempt to harm someone
else which also includes threats against other people. So
assault is planned attempt to violently harm another
person.
Eg : Trying to punch a person is an assault.

16.  FALSE IMPRISONMENT
It is intentionally restraining another person without
any legal right to do so.

17. A wonderful act based on speech committed by a
person so entity against another person or entity that
causes economic harm or damage to reputation.
 DEFAMATION
Defamation is the issuance of a false statement about
another person’s reputation which causes that person
to suffer harm.

18.  FRAUD
Fraud is a crime or offence of deliberately deceiving
another in order to damage another-to obtain property
or services.
Eg : Trying to obtain a higher position by giving
incorrect information to the prospective employer.

19. A wrong occurring to another person leading to
injury even though it was not intended .
Negligence and malpractices are examples of
unintentional torts.

20.  NEGLIGENCE
Negligence is an individual to do something that are
responsible prudent person would do or the
commission of the act in particular circumstances in
standard of care to which a nurse is legally bound,
would not do under similar circumstances.

21.  Failure to use aseptic technique were required.
 Leaving a foreign object in a patient’s body
during surgery.

22.  Administering wrong medication to a patient.
 Administering a care in such a manner that a
person suffers injury.
 Failing to protect and inform patient from failing,
false resulting injuries to patients.

23. Malpractice occur when an improper, injurious or
faulty treatment of a client that results in illness or
injury.
Eg:
 Failure to take appropriate precautions.
 Failing to report another’s mistake.
 Failure to follow a physician’s orders.

24.  Delaying patient care.
 Incorrectly performing a procedure.
 Documentation error.
 Failure to get informed patient consent.

26. REGISTRATION
Licensing is a mandatory procedure for practice of
nursing. Registration aims at protecting patients by
providing qualified nurses. The nurse is responsible
to obtain registration in the respective State
Nursing Registration Council.

27. LEGAL LIABILITY/ACT OF
NEGLIGENCE
License of a nurse can be suspended or cancelled
for any act of negligence or malpractice, following
a specified procedure.

28. A medico legal case is defined as a patient who
is admitted to the hospital with some
unnatural pathology and has to be taken care of
in concurrence with the police and/or court.

29. The responsibilities of the nurse in MLC include
the following ;
 Obtain detailed history from the patient
 Inform casualty medical officer(CMO) where the
patient is brought for initial treatment
 Record MLC on the case sheet
 If patient absconds, inform CMO

30.  No MLC Patient can be discharged
against medical advise(DAMA).
 Document the care given to the patient appropriately
 Keep all records of the patient while the patient is
in hospital, safely handover to the person designated
by the hospital authority.
 In case of death of the patient , the body to be kept
in mortuary and inform CMO.

31.  CORRECT IDENTITY
A nurse/midwife is responsible to make sure that
all babies born in hospital are correctly tagged at
birth and handed over to right parent.
Unknown/unconscious patients must be labeled
as soon as their identity is known. Patients who
have to undergone surgery should be appropriately
identified and labelled.

32. Site of operation to be correctly marked particularly
where symmetrical sides or organs are there. Scrub
nurse has to see all the instruments/ swabs are
returned. She has to say “OKAY” before closure by
the Surgeon.

33.  LEFT AGAINST MEDICAL
ADVICE (L.A.M.A.)
Inform medical officer in charge. Signatures of both
patients and witness to be taken as per institutional
policy.

34.  PATIENT'S PROPERTY
Inform patient on admission that hospital does not
take responsibility of his belongings. If patient is
unconscious then a list of items must be made,
counter checked by two staff nurses and kept under
safe custody.

35. DELEGATION
Delegation is the transfer of responsibilities with
authority from one person to another to carry out
specific activities. It is one of the most complex
nursing skills that maximizes the available resources
in the interest of patient care. Effective delegation is
based on understanding of the concepts of
responsibility, authority and accountability.

36. DYING DECLERATION
Doctor or nurse should not involve themselves in
dying declaration in case where police records the
dying declaration. It is to be recorded by the
magistrate. But if condition of patient becomes serious
then medical officer can record it along with two
nurses for witness.

37. It can also be recorded by the nursing staff with
two nurses as witness when medical officer is
not present and the declaration has to be sealed
and send as soon as possible.

38.  INFORMED CONSENT
Informed consent is an obtaining permission
voluntarily from a client before conducting a
healthcare intervention. It is the process of
communication between a client and a healthcare
provider that enables the clients authorization or
agreement to undergo a specific healthcare
intervention.

39. Informed consent is obtained by the healthcare
provider after explaining:
 The health problem, necessity and reason for
the treatment.
 Course of treatment and expected benefit of
treatment.
 The risk of treatment and how likely they are
to occur.
 Possible side effects that may happen later on.

40. WILL
Doctor has to be present there, he can record
if requested.
 EXAMINATION OF RAPE CASE
Female attendant/female nurse must be present
during the examination.

41. ARTIFICIAL HUMAN INSEMINATION
 Written consent should be obtained from both
donor and recipient.
 Donor and recipient must have the same blood
group.
 All related documents should be kept confidential
& safe.

42. VIOLENCE,NEGLECT,ABUSE
VIOLENCE
Violence has been defined as physical, sexual, or
emotional, psychological, violence directed
towards men, women, children or elders occurring in
current or past intimate relations whether individuals
are cohabiting or not.

43. The intentional use of physical force or power,
threatened or actual, against oneself, another
person, or against a group or community, which
either results in or has a high likelihood of
resulting in Injury, death, psychological harm,
man development or deprivation.

44. ABUSE
Abuse is when a person hurts another person, either
physically or emotionally. It is the improper use of
something .
Abuse can come in many forms such as physical or
verbal mal treatment, injury, assault, violation, rape,
unjust practices, crimes or other types of aggression.

45. Neglect is a failure to provide the necessary care,
aid or guidance to dependent adults or children
by those responsible for their care. Neglect may
include the failure to provide sufficient
supervision, nourishment, or medical care, or
failure to fulfill other needs for which the victim
cannot provide themselves.

46. An inquest is a judicial inquiry or investigation
to determine the cause of a person's death where
the death has occurred under mysterious and
suspicious circumstances.

47. There are four types of inquest:
 The Police inquest (by a police officer)
 The Coroner's inquest (by a coroner; but now,
it is not conducted in India)
 The Magistrate's inquest (by a Magistrate)
 The Medical Examiner system (by an official
who is legally and officially qualified).

49. Good Samaritan laws are laws that have been
enacted to protect the health care professional
from legal liability for action rendered in an
emergency when the professional is giving
service without pay.

50. Now a days increase in the number of
professional negligence lawsuit against health
professionals, nurses are advised to carry their
own liability insurance. Most hospitals have
liability insurance that covers all employees,
including all nurses.

51. A primary care provider or a hospital can be used
because of the negligence conduct of a nurse, and
the nurse can also be used and held liable for
professional negligence .

52. Nurses are expected to analyze procedures and
medications ordered by the physician or primary
care provider. It is the nurses responsibility to seek
clarification of ambiguous or seemingly erroneous
orders from the prescriber. Clarification from any
other source is unacceptable.

53. Keeping accurate and comprehensive records are
essential in health care facility. Records provide a
legal and business documents. Regardless of the
format used to record data should be accurate
concise and up to date.

54. Standards of care is based on an unwritten
usually acceptable way of giving care. This is
supported by nurse practice act. In every hospital
where you are working will have written policies
and procedures, and you will be responsible for
following these.

55. Nurses are required to execute prescribed orders.
In case of emergency or the doctor or medical
personal is not available each nursing service
area should have standing instruction or orders
for nurse to carry out.

56. It is a clients agreement to allow something to
happen, such as surgery based on full disclosure of
the risks, benefits, alternatives and consequences of
refusal.

58.  Nursing care is based on quality assurance model.
 Nursing care is professionally managed and ethically
justified.

59.  Nursing care is provided within the legal
framework.
 Nursing care is documented accurately and
completely.
 Nurse accepts responsibility and accountability
for own actions.

60.  Nursing care reflects adherence to practice
standards.
 Delivery of nursing care reflects nursing
process approach.
 Nursing care is provided in a safe environment.

61.  Nurse fosters effective interpersonal relationship
with individuals and families.
 Nurse initiates strategies to promote the learning of
individual and groups .

62.  Nursing care enhances the dignity, individuality
and self esteem of individuals and groups.
 Nursing care reflects active pursuit for rights of
all individuals and in particular the vulnerable
groups.
 Nursing care reflects gender sensitivity towards
the need of women to their health.

63.  Management of nursing services reflects the use of
effective techniques.
 Management of nursing services reflects the use of
quality assurance model.

64.  Management of nursing services contributes to
development and implementation of
institutional policies in conformity with
statutory regulations.
 Management of nursing services develops and
implements staff development and welfare
programmes.

65.  Nursing care reflects the commitment to ongoing
education and professional growth of self and others.
 Nursing care includes activities which focuses on the
advancement of profession.

67. It refers to a method and enquiry of people to
understand the morality and human behavior.
It refers to the practices and beliefs of a particular
group.

68. It refers to ethical Issues that cause in nursing
practices.
ETHICAL PRINCIPLES :-
 Autonomy
 Non - maleficence
 Beneficence
 Justice
 Fidelity
 Veracity

69. It refers to right to make ones own decision.
The nurse who follow this principle recognize
that each client is unique, has the right to be what
that person is, and has the right to choose
personal goals.
Eg: The client/family may expect the health care
provides to respect their right to refuse a
treatment.

70. It refers to do not harm though is seen be a
simple principle to follow in reality .It is
complex harm can mean intentionally and
unintentionally .
Eg: Discussion of advance directives and issues
such as cardio pulmonary resuscitation may be
viewed as physically and emotionally harmful to
the client.

71. It is referred to as Fairness. Nurses often
face decisions in which sense of justice should be
prevail.

72. It refers to faithful agreement and & progresses.
Since nurses are working as professional care
giver they have responsibility to clients,
employees, government and society as well as to
themselves.

73. Veracity refers to tell the truth. Although this
seems straight forward in practice, choices are
not always clear.

75. This is the life saving measures according to the
agency policy unless the primary physician has
written a“ do not resuscitate order” in the clients
medical order. Health care agencies are required to
have policies for a DNR decision. The principles of
informed consent respected by physician who writes
a DNR order.

76. Nurses are usually required to notify the physician
and nurse supervisor before acting as a witness and
signing a will. Nurses should refrain from assisting
the client with the wording of the will at this should
be done with legal advice from an advocate.

77. The government has formed laws to protect the public
when dealing with issues of death. The various
definitions of death are as follows: The absence of
awareness of external stimuli, lack of movement or
spontaneous breathing, absent reflexes, a flat brain
wave or EEG and definition of brain death, which
requires irreversible cessation of all functioning of the
brain.

78. When the client dies, the nurse is responsible to
treat the deceased with respect and dignity. The
nurse should prepare the body for removal to the
mortuary according to the agency policies, the
nurse is responsible for properly identifying the
body could result in severe distress for the family
as well as legal ramifications for both hospital
and the nurse.

79. The donation of organs for transplantation is a
matter that requires compession and sensitivity from
the care givers. It is important that family of the
deceased know the importance of and process for
organ donation. It requires the collaborative efforts
of the nurse with physician, social workers and
clergy to ensure timely removal of the organs.

80. An autopsy is performed to determine the cause of
death. The cause of death also has to do for
payment from insurance policies and the workers
compensation. It requires consent in writing and
nurse is responsible for ensuring that all
documentation is in place before releasing a body
for autopsy.

81. It is merci- killing. This means easy or painless
death.
Two types:
a) Active euthanasia: it is to take deliberate
action to end the patients life.
b) Passive euthanasia: it is stopping from
treatment that would prolong a persons life
such as chemotherapy, surgery, antibiotic
therapy but taking no steps to end his life.

82. The concept has to develop as a mechanism for
dealing with some of the decisions that arise for
caring for terminally ill. When there is no hope
for recovery. Advanced directives incorporate,
the concept of living will, the patients right to
refuse unwanted life support, such as CPR,
antibiotics, food and fluids.

83. 1. An advance directive tells the health care
team what kind of care patient would like to
have if he is unable to make medical
decisions.
2. A good advance directive describes the kind
of treatment the patient would want
depending on the sickness.

84.  Abuse of children , elderly and spouse
 Drug related injury
 Unknown cause of death
 Suicide
 Violent death
 Poisoning
 Accidents
 Suspicion of criminal action

85.  All nursing observations should be noted
carefully, describing accurately.
 Patients complaints should be recorded as
accurately and specifically.

86.  Nurse must report through proper channels.
 Authorities must be informed regarding any
kind of equipment, materials or supplies,
which for any reasons less than safe for use in
the patient's care.
 Insurance protection.

87. Medico legal issues have to be dealed with
properly following the latest prevailing
guidelines. Even if due guidelines or procedures
are not followed or not available, this cases pose
no problem if one uses proper caution and due
care and attention while dealing with them.

88. Proper documentation, timely information,
methodical and thorough information including
all relevant investigation and referrals etc are all
that are necessary to see such cases completed
successfully.