Legal Principles in Nursing Practice

Legal Principles in Nursing

• Laws prescribe how people should act in society.
• Health care workers can be held civilly or criminally liable depending on case specifics.
• Standards of care are legal requirements for nursing practice outlining minimum acceptable care.
• Turkish Nurses Association (TNA) develops and sets nursing practice standards.

Civil and Common Law Issues in Nursing Practice

• A tort is a civil wrong against a person or property, categorized as intentional, quasi-intentional, or unintentional.
• Intentional torts include harming someone (battery) or damaging someone's reputation (defamation).
• Quasi-intentional torts involve acts where harm wasn't intended, but the action caused wrong, like accidentally invading privacy.
• Unintentional torts commonly involve accidents or mistakes, including negligence (e.g., giving wrong medication).

Intentional Torts (Assault and Battery)

• Assault occurs when a healthcare provider threatens physical harm, even without physical contact.
• Battery involves intentional touching without consent, like threatening or administering an injection without consent.
• The key aspect is patient consent.

Quasi-intentional Torts (Invasion of Privacy)

• Invasion of privacy involves releasing a patient's medical information to unauthorized individuals (e.g., press, employer, family members).
• Patient medical records information is confidential and meant for medical treatment use only.

Unintentional Torts (Negligence and Malpractice)

• Negligence is conduct falling below a standard of care (e.g., a driver failing to stop at a stop sign).
• Malpractice is negligence within a professional context, requiring specific criteria to establish:
  • A duty to the patient was owed.
  • The duty was not fulfilled.
  • The patient was injured.
  • The failure to fulfill duty caused the injury.

Causes of Medical Malpractice Claims (2017-2021 Statistics)

• Diagnosis-related issues make up 26% of claims.
• Treatment-related issues represent 28.5% of the claims.
• Surgery-related issues make 24.1% of the claims.

Consent

• Signed consent forms are needed for all routine procedures, hazardous procedures (surgery, chemotherapy), and research involving patients.
• Patients sign general consent forms upon admission to a facility.
• Separate consent forms cover specific procedures.
• Nurses should be knowledgeable of their state laws and their employer's policies regarding consent.
• Informed consent is a patient's agreement to a procedure and must be given willingly when not an emergency.

Nursing Students and Liability

• Nursing students are liable if their actions cause harm to patients.
• Institutions and instructors share liability for incorrect student actions.
• Nursing students are expected to demonstrate the same level of skill as professional nurses.

Abandonment and Assignment Issues (Health Care Providers' Orders)

• Health care providers (physicians and advanced practice nurses) direct medical treatment.
• Nurses follow orders unless actions are seen to be harmful or in error.
• The nurse should check all orders for mistakes and harmful implications. Clarification is necessary from the health care provider when needed. 

Theoretical Foundations of Nursing

• Theory-based nursing practice is essential for designing and implementing nursing interventions.
• Expertise in nursing is a blend of knowledge and clinical experience.
• Nurses use well-established theories to guide their patient care.
• Nursing theories are organized bodies of knowledge defining what nursing entails, what nurses do, and why nursing is done in a unique way distinct from other disciplines(like medicine for instance).
• Nursing theories are frameworks to guide practice.

History of Nursing Theories

• The first nursing theories emerged in the late 1800s.
• Florence Nightingale defined nursing in her Environmental Theory, focusing on environmental improvement.
• Hildegard Peplau's Interpersonal Relations Theory focused on the nurse-patient relationship.
• Virginia Henderson defined nursing based on assisting patients meet basic human needs.

Classification of Nursing Theories

• Grand theories have broad scope.
• Middle-range theories address specific nursing phenomena.
• Practice-level theories (micro-range) are used to guide daily nursing actions.

The Nursing Metaparadigm

• It is a framework to understand fundamental concepts in nursing (person, environment, health, nursing).
• The concepts give structure to nursing.
• The person includes individuals, groups, families, and communities that are recipients of care.
• Environment includes internal and external factors affecting the individual. 
• Health involves wellness factors.
• Nursing represents the actions nurses use in their practice to help clients recover.

The Domain of Nursing

• Nursing diagnoses and treats human responses to health issues (actual or potential).
• The scope is broad (a nurse does not diagnose, but asses reactions to decreases in tolerance for example).
• The nurse develops nursing diagnoses of related responses to health and illness.

Grand Theories

• Grand theories encompass broad, conceptual ideas about nursing.
• Florence Nightingale's Environmental Theory: important role of the environment in healing (fresh air, cleanliness, light).
• Dorothea Orem's Self-Care Deficit Theory: Nurses assist in self-care when the individual cannot.

Middle-Range Theories

• More focused and specific than grand theories.
• Patricia Benner's Novice-to-Expert Theory: Description of how nurses move through stages of expertise over time.
• Pender's Health Promotion Model: Encourages actions to maintain health or seek improvement.

Practice-Level Theories

• Very specific, daily nursing actions.
• Theory of Wound Healing: Describes methods for wound care.
• Postpartum Depression Theory: Focus on support for mothers who may experience postpartum depression.

Nursing Theorists

• Florence Nightingale: Environmental theory.
• Hildegard Peplau: Interpersonal relations theory.
• Virginia Henderson: Nursing Need Theory
• Faye Glenn Abdellah: 21 Nursing Problems Theory.
• Ida Jean Orlando: Nursing Process Theory.
• Myra Estrin Levine: Conservation Model.
• Joyce Travelbee: Human-to-Human Relationship Model
• Betty Neuman: System Model
• Sister Callista Roy: Adaptation Model
• Dorothea Orem: Self-care theory

Nursing Models

• Maternal Role Attainment Theory: Focus on mothers' role development and infant care process
• Self-Efficacy Theory: Importance of an individual belief that they can manage their own health in relation to behavior, environment and personal factors.
• Life Perspective Rhythm Model: Includes person, health, environment, and nursing.
• Health Promotion Model: Directs focus on increasing a patient's level of well-being to promote improvement/change in areas of individual characteristics and experiences, behavior-specific cognitions and affects, and behavioral outcomes

Many nursing education institutions use Gordon's functional health patterns to collect patient data.

Continuing Evolutions of Nursing Theory

• Nursing practice deeply entrenched in legal and theoretical bases.
• Nurse theorists influence modern nursing practice.

This quiz covers key legal concepts that nurses must understand, including the implications of civil and common law in healthcare. It discusses the standards of care, various types of torts, and the role of nursing practice standards set by the Turkish Nurses Association. Test your knowledge of these essential legal principles in nursing.