Legal systems

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ChapterNo.15.pdf

Law and the

Professional Nurse

Chapter 15

Sources of Law

• Statutory law

• Administrative law

(regulatory)

• Case law

• Enforcing the law

– Civil

– Criminal

Civil Case Flowchart

Complaint

Answer

Trial setting conference

Trial

Judgment

Settlement conference

Settlement

Compulsory arbitration

Notice of decision/aw

ard

Dismissed Appeal and

motion to set trial

Judgment

Dismissed without

prejudice

Application for default judgment

Default judgment

Nursing Scope and Standards

• Nursing scope of practice describes who, what,

where, when, why, and how of nursing

practice

• Standards of nursing practice defined as

“authoritative statements of the duties of all

registered nurses, regardless of role,

population or specialty, are expected to

perform competently”

Professional Performance Standards

• Ethics

• Education

• Evidence-based

practice and research

• Quality of practice

• Communication

• Leadership

• Collaboration

• Professional practice

evaluation

• Resource utilization

• Environmental health

• Cultural congruence

Standards: State Boards of Nursing

• Develop scope of practice statements for licensure

• Expand scope statements for advanced practice

nurses

• Make decisions about new practices and procedures

• Define new categories of licensure, recognition, and

certification

• Determine appropriateness and level of discipline

• Define state accreditation of nursing educational

programs

Evidence of Standards of Care

Used in Court

• Statutes

• Agency regulations

• Accreditation standards

• Facility documents such as policies and procedures, job

descriptions

• Professional nursing guidelines

• Manufacturers’ instructions related to medical equipment

• Nursing literature

• Expert testimony

Negligence and Malpractice

• Negligence is defined as the failure to act as a

reasonably prudent person would have acted in

a specific situation

• Malpractice is the failure of a professional to

use such care as a reasonably prudent member

of the profession would use under similar

circumstances, which leads to harm

Elements to Prove in Successful

Malpractice Case

• Duty owed to the patient

• Breach of the duty owed the patient

• Foreseeability

• Causation

• Injury or harm

• Damages

Avoiding Malpractice and Negligence

• Manage stress

• Adhere to standards of care

• Work in environments that encourage

examination of incidents

• Change systems to lower the risk of

malpractice

Nursing Licensure

• Registration

• Mandatory licensure

• Certification

• Endorsement

• Nurse Licensure Compact

• National Council of State Boards of Nursing

initial licensure exam (NCLEX)

The Nursing Licensure Compact

Explained Video

https://www.ncsbn.org/364.htm

State Boards of Nursing

• Obligation to protect safety of public

• Nurse Practice Acts

• Disciplinary actions

• Alternative programs

Board of Nursing Complaint Process:

Investigation to Resolution Video

https://www.ncsbn.org/426.htm

Informed Consent

• A brief but complete explanation of the patient

diagnosis and proposed treatment or procedure

• The name and qualifications of the person who will

perform the procedure or treatment

• Information related to available alternatives to the

recommended treatment

• Information related to possible complications of the

treatment or procedure

• An explanation related to the patient’s right to refuse

treatment without having care discontinued

Standards of Informed Consent

• The medical standard—what is regarded as a

material risk in the medical community

• What a reasonable patient would need to know

• What a particular patient needs to know

Nurse’s Role in Informed Consent

• Facilitating informed consent for patient care

as a part of providing patient-centered care

• Advocate for patient

• Witness to patient signature

Transparent Health−The Story of

Michael Skolnik Video

https://youtu.be/n83gd1piUu4

Privacy and Confidentiality

• Privacy is the right of a person to be free from

unwanted intrusion into the person’s personal

affairs

• Confidentiality of patient information is the

obligation of all healthcare providers

HIPAA (1 of 2)

• Patients must be informed of their privacy

rights

• Patients must be informed as to who will see

their records and for what purpose

• Patients have the right to inspect and obtain a

copy of their medical records

• Personal data may not be used for marketing

HIPPA (2 of 2)

• Valid authorization to release health information

must contain certain information, such as a copy

of the signed authorization given to the patient, in

understandable language, and information about

how the patient may revoke this authorization

• Although information may be used for research

purposes to assess outbreak of a disease, all

individual identifiable data must be removed

Your New Rights Under HIPAA Video

https://youtu.be/3-wV23_E4eQ

HIPAA Complaint Process

Five Rights of Delegation

• The right task

• The right circumstances

• The right person

• The right direction and communication

• The right supervision and evaluation

The National Council of State Boards

of Nursing’s Delegating Effectively

Video

https://www.ncsbn.org/378.htm

Model of Professional Nursing

Practice Regulation

http://www.nursingworld.org/modelofpracticereg

ulation