Legal System, Legal Issues Management Presentation
Legal System, Legal Issues Management Presentation
Legal System, Legal Issues Management Presentation
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INTRODUCTION:
It is important for nurses to know the basic legal concepts because nurses are accountable for their
professional judgments and actions.
Knowledge of legal aspects in nursing is absolutely essential for each nurse to safeguard self and
clients from legal complications. Consumers are becoming increasingly aware of their legal rights
in the health care. It is essential; therefore a nurse should know her legal and professional
boundaries.
DEFINITION:
Laws are “rules of conduct, established and enforced by authority, which prohibit extremes in behavior
so that one can live without fear for oneself or one’s property”.
NURSING LAW is 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.
LEGAL RESPONSIBILITIES in nursing means to practice nursing within the guidelines laid down by
the law of center/state, statutory bodies and institutional policies
TYPES OF LAW:
1. Common law- Created by judicial decisions made in courts when individual cases are decided
2. Criminal law- Prevent harm to society and provides punishment for crime
3. PUBLIC LAW- determines your relationship to the federal government and the states.
4. Civil law- It regulate relationship among people. It includes laws relating to contract, ownership
of property and the practice of nursing, medicine, pharmacy and dentistry
6. CONSTITUTIONAL LAW- is the type of public law that considers your rights and
responsibilities under the federal and state constitutions. Patients right to life, right to die,and right
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to self determination in refusing treatment, rights to life, liberty and religious freedom are all
founded in constitutional law.
7. CRIMINAL LAW- it deals with the major and minor crimes. The crime involves the deliberate
commission of the act forbidden, or omission of an act required by the law
It prevents harm for society and provide punishment for crime
10. Comparative Law: The comparative lawyer works with international relations in trade and
commerce, travel, government business
11. Family law: The most common family law attorneys are the divorce lawyers, but other aspects of
family law are represented as well. Child support claims and those stipulations, custody
It provides a framework for which nursing actions in the care of clients are legal
protect clients’ rights
It helps to make boundaries of independent nursing action.
It assists in maintaining a standard of nursing practice by making nurses accountable under the
law
IMPORTANCE OF LAW
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LEGAL LIABILITIES IN NURSING/TORTS:
Liability is anything that is a hindrance, or puts individual at a disadvantages. In law a legal liability is a
situation in which a person is liable, and is therefore responsible to pay compensation for any damage
incurred; liability may be civil or criminal.
When the nurse fails to meet the legal expectations of care, the client can initiate action if harm or injury
incurred by the client. These are mostly as unintentional torts(negligence and malpractice) and intentional
( assault, battery, false imprisonment, intentional infliction of emotional distress and fraud.
Definition:
A tort is a legal wrong, committed against a person or property independent of a contract which renders
the person who commits it liable for damages in a civil action.
TYPES OF TORT:
Torts
Unintentional Quasi
Intentional tort
tort intentional tort
Invasion of Defamation of
Battery Negligence Fraud
Privacy character
False
Imprisonment or Libel
Illegal Detention
Criminal battery
Civil battery
1. Intentional torts: These are when others interfere in individual's privacy, mobility, property or
personal interests. These rights of individual's should be protected.
Intentional torts can be:-
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Assault- it is an unjustifiable attempt to touch another person or the threat to do so in such
circumstances as to cause the other reasonably believe that it will be carried out
Battery- is an assault that is carried out and includes every willful, angry and violent and
negligent touching of another persons body or clothes
False imprisonment- it is a intentional act which prevents an individual from moving about
where she wants to be.
Criminal battery
Civil battery
2. Unintentional torts : These types of torts are accidents that cause injury to another person or property.
Negligence: It is conduct that falls below the standard of care that a reasonable person ordinarily
would use in a similar circumstances or it is described as lack of proper care and attention carelessness.
E.g.: 1) Medication errors
2) Burns, falls, failure to observe, use of defective equipment’s, loss of patient property, patient
mix up.
ELEMENTS OF MALPRACTICE
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3. Quasi intentional Torts:
DEFAMATION: Defamation is the communication of a statement that makes a claim, expressly stated
or implied to be accurate, that may give an individual, business, product, group, government, religion or
nation a negative or inferior image.
It can be also any disapproving statement made by one person about another, which is communicated or
published, whether true or false, depending on legal state.
TYPES OF DEFAMATION
1. SLANDER
Slander is oral defamation of a person by speaking unprivileged or false words by which his
reputation is damaged.
2. LIBEL
Libel is defamation by written words, cartoons or such representations that cause a person to be
avoided, ridiculed, or held in contempt or to tend to injure him in his work.
Good faith
Public good
Justification
Fair comment
Privilege
Apology
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LEGAL MALPRACTICE IN NURSING:
Medication errors
Failure to follow a physician‘s order
Delaying patient care and/or failure to monitor a patient
Incorrectly performing a procedure, or trying to perform a procedure without training
Documentation error
Failure to get informed patient consent
CRIMINAL(IPC) CIVIL
Code (IPC) (e.g. wrong medication e.g. not giving railing bed to unconscious
License of a nurse can be suspended or cancelled for any act of negligence or malpractice,
following a specified procedure
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3. MEDICO-LEGAL CASE (M.L.C)-
A medico legal case is 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.
• Suicide
• Homicide
• Burns
• Poisoning
• Rape victim
• Assaults
2. Inform the police officer/constable on duty in the hospital and the CMO.
3. When it is made a MLC, then record it on the patient's case sheet with red ink at right hand top comer
4. Do not give any statement about patient's condition to police, magistrate or media. Only a doctor has to
give information
5. When a patient has to be discharged, inform the police officer/constable on duty in hospital and/or the
CMO. After clearance from them, then only he/she can be discharged
6. If a MLC patient absconds inform the CMO immediately and the treating doctor
8. Document the care given to patients timely. Accurately and duly sign the nurses notes
9. Records and all documents pertaining to patient should be handled with care. During the stay in the
hospital. They must be kept safely and should be handed over to the authorized person as designated by
the hospital authority
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10. In case of death of a MLC. The body is not to be handed over to the relatives. It needs to be
accurately labeled and sent to the mortuary CMO and/or police officer should be informed
simultaneously
4. CONSENT
• "Every adult his body of sound mind has a right to determine what shall be done with.
The patient must be able to understand the choices he or she is required make
The procedure for which consent is sought must have been explained to the patient. It may be
negligent to withhold important information
< 12 years can't give consent even for general physical examination. It must come from
parent/guardian.
12-18 years can give consent for general physical examination only
18 - consent must come from patient himself/herself except in certain circumstances
Consent - should come from parent/guardian/ significant others in case of patients who are not in a
capacity to decide for themselves such as: patient with dementia / delirious patient / mentally
challenged/ deaf and mute/ patients with mental disorders/ unconscious/ gravely ill etc.
5. Correct Identity:
A nurse/midwife is responsible to make sure that all babies born in hospital are correctly labelled
at birth and handed over to right parent.
Unknown/unconscious patients must be labelled as soon as their identity is known
• Patients who have to undergo surgery should be appropriately Identified and labeled.
Site of operation to be correctly marked particularly where symmetrical sides or organs are there.
Operation Theatre (O.T.): Scrub nurse has to see that all instruments/swabs are returned. She has
to say 'OKAY before closure by the surgeon.
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6. Left against Medical Advice (LAMA):
• Inform medical Officer Incharge. Signatures of both patients and witness to be taken as per
institutional policy.
7. Patient's Property:
• Inform patient on admission that hospital does not take responsibility of his responsibility.
• If patient is unconscious/or otherwise required, then a list of it must be made, counter checked by
two staff nurses and kept under safe custody
8. Dying Declaration:
• Doctor or nurse should not involve themselves in dying declaration, in case where police records
the dying declaration.
• But if condition of patient becomes serious then Medical Officer can record it along with two
nurses as witnesses.
• Dying declaration can be recorded by nursing staff with two nurses as witnesses when Medical
Officer is not present. Then the declaration to be sent immediately under sealed cover to the
Magistrate.
9. Wills:
Do not give either verbal or written opinion. Do not allow to take photos unless special
permission is granted by appropriate authority
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Do not give any information to public or press
Preserve all evidence of poisoning
Collect and preserve all excreta, vomitus and aspirates, seal them immediately and send to
forensic laboratory at the earliest.
Consumer Protection Act (CPA) was passed by the Parliament in 1986 to provide for
Consultation of the interest of consumers and focuses on consumer justice through the
establishment of consumer councils and other authorities for the settlement of consumer’s
disputes and matters connected therewith the slope of et is wide enough to conclude a vast variety
of services.
Under this act consumer can complain in redressal forum. It enables the consumer/ patient to
make a complaint to a redressal forum in respect of defective services vided
• Right of Safety
• Right to be informed.
• Right to Choose.
• Right to be heard.
1. Review nursing practice periodically. Update knowledge and improve stall by attending short
term courses, In-service education and continuing education programmers.
2. Should have complete knowledge of all rules and regulation of hospital and know their job
descriptions (duties and responsibilities),
4. Be a keen observer
5. Written instructions must be displayed in all nursing units for necessary guidance and
protection of the staff regarding issues related to patient care
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6. All hospitals must have rules and code of practice laid down to ensure the safety and well
being of patients and nurses.
8. Follow 6 R's - right patient. right drug, right dose, right time and right route with right
technique.
9. Check the treatment order and use professional judgment before implementing
10. Do not attempt anything beyond level of competence and scope of nursing practice. If there is
any doubt in mind, seek advice from professional colleagues,
11. Do not exceed the limits of nursing procedure laid down by statutory bodies.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that
required the creation of national standards to protect sensitive patient health information from
being disclosed without the patient’s consent or knowledge. The US Department of Health and
Human Services (HHS) issued the HIPAA Privacy Rule to implement the requirements of
HIPAA. The HIPAA Security Rule protects a subset of information covered by the Privacy Rule.
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Laws applicable to nursing practice:
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Responsibility in quality control: Nurse Administrator must ensure and report quality of nursing
services.
Responsibility for equipment: To protect the patient and employee from injury, the nurse manager
must ensure that all patient care equipments are fully functional and defective equipments are
promptly repaired or replaced
Responsibility for death and dying
Responsibility for observation and reporting
CONCLUSION:
A number of legal issues are related to nursing practice, including licensing, nurse practice acts, and
standards of care. However, in these litigious times, the issue that most concerns those considering a
career in nursing are negligence and malpractice.
Every nurse should act as per the legal guidelines for nursing practice while caring for patients.
Nurses have a responsibility of seeing that no harm comes to their patients and also to themselves
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BIBLIOGRAPHY:
Vati J.Principles & practice of Nursing management & Administration For Bsc & Msc
Nursing.1st ed.jaypee brothers publishers: Newdehi;2013.
Clement I. Management of nursing services and education. elsevier publishers:New Delhi;2014
https://www.slideshare.net/ajeshktk/laws-torts
https://www.slideshare.net/lindadevi1/legal-issues-in-nursing-ppt-1188990
https://www.slideshare.net/hanna_priyanka/law-and-nursing-practice
https://www.slideshare.net/Joevet/legal-liabilities-in-nursing
https://uc.xyz/2aRDYX?pub=link [Medico - Legal Aspects | Nursing | Negligence]
https://www.slideshare.net/JaysGeorge/ethical-and-legal-issues-in-nursing
Das.D.M.H. Medico Legal Aspects in Nursing, Ram Lal Pury of Atma Ram &Sons publishers:
New Delhi
Ford D.R Nurses Legal Handbook
Mehta H.S Medical Law and Ethics in India: The Bombay Samachar Private LTD
RESEARCH ARTICLE
Nursing and Midwifery Malpractice in Turkey Based on the Higher Health Council Records
Ümit N Gündoğmuş, Erdem Özkara, Samiye Mete
Abstract
Background:
Medical malpractice has attracted the attention of people and the media all over the world. In Turkey,
malpractice cases are tried according to both criminal and civil law. Nurses and midwives in Turkey
fulfill important duties in the distribution of health services.
Objective:
The aim of this study was to reveal the legal procedures followed in malpractice allegations and
malpractice lawsuits in which nurses and midwives were named as defendants.
Method:
We reviewed 59 nursing and midwifery lawsuits reported to the Higher Health Council between 1993
and 1998.
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Result:
Health professionals were held liable in 59% of the lawsuits. Midwives had the highest percentage of
malpractice liability (52%), followed by physicians (29%) and nurses (19%).
Conclusion:
To reduce potential liability, nurse education should be improved, a nursing malpractice law should be
enacted, and instructions for nursing procedures should be formulated.
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