Accountability in Nursing Practice PDF

Accountability to the profession RESPONSIBILITY AND As a nurse you are accountable to ACCOUNTABILITY FOR THE meet the standards of your & PRACTICE...

Accountability to the profession RESPONSIBILITY AND As a nurse you are accountable to ACCOUNTABILITY FOR THE meet the standards of your & PRACTICE OF PROFESSIONAL profession. - NURSING These standards may be contained in ❖ Nurses employed in an agency, the & Nursing Act itself or in institution or hospital are directly Regulations accompanying that Act. responsible to their immediate supervisors. NURSING JURISPRUDENCE ❖ Private duty nurses, being Department of & law which comprise independent practitioners, are held all legal issues and principles to a standard of conduct that is - affecting the practice of nursing. expected of reasonable prudent Juris: Laws & nurse. Prudentia: Wisdom - ACCOUNTABILITY LAW Able to give an account of one’s Rule of civil conduct prescribed by - nursing judgements, actions and the supreme power in a state & omissions. commanding what is right and - Maintaining competency and prohibiting what is wrong. - safeguarding quality patient care Sum total of rules and regulations by outcomes and standards of the which society is governed. profession, while being answerable to those who are affected by one’s Nullum crimen nulla poena sine lege nursing practice. ➔ “There & is no crime, if there is no law - punishing the act”. - ACCOUNTABILITY TO THE CLIENT - Nurse to client ➔ The moral principle in criminal law The foremost accountability of the and international criminal law. nurse is to the client. You hold yourself out to the client as Ignorantia juris non excusat - someone having the special ➔ “Ignorance of the law, excuses no - - knowledge, training and skills one” - - - - - associated with nursing. ➔ Ignorance of the law is no defense as the legal maxim is firmly grounded ACCOUNTABILITY TO THE EMPLOYER in criminal law and firmly excluded As an employee you have the & from the realm of civil disputes. responsibility - to work within the scope of employment as defined by BASIC FUNCTIONS OF LAW IN THE SOCIETY - the employer.- You are- responsible to know your 1. To define relationships among terms of employment, and to work members of a society and state within those terms. which activities are permissible or not. ACCOUNTABILITY TO THE PROFESSION 2. To describe what forces may be applied to maintain rules and by when is to be applied.  3. To provide solutions to problems state in its political or 4. To refine relationship between sovereign capacity. person and group when conditions A law that applies generally of life change. to people of the state adopting or enacting it. FUNCTIONS OF LAW IN NURSING Punishments: fines and/or 1. It provides a framework for imprisonment establishing what nursing actions in 1. Criminal Law the care of patients. 2. International Law 2. It delineates the nurse’s 3. Political Law responsibilities from those of other health practitioners. Criminal Law 3. It helps to establish the boundaries Branch of jurisprudence which of independent nursing care action. - teaches of the nature, extent and - 4. It assists in maintaining a standard degree of every crime and adjusts to - of nursing practice by making nurses it the adequate and necessary - accountable under law. penalty. & Law of the Nation TYPES OF LAW ACCORDING TO SOURCE International Law > - OF AUTHORITY aka Law of the nations 1. Divine Law & The law which regulates the Laws authored by God > 10- commandments intercourse of nations. 2. Human Law 1. Public International Law & Laws authored by men 2.-Private International Law TYPES OF HUMAN LAW 1. Public International Law 1. Public Law & The body of rules which Body of law for the welfare of control the conduct of & the general public indepedent state in their - Relationship between relation to each other. & individuals and the government agencies 2. Private International Law > Conflict - of laws 2. Private aka - conflict of laws & Body of law that deals with Part of the law of each state relationship among private which determines whether, individuals. in dealing with a legal It can be categorized into a situation, the law of some variety of legal specialities other state will be such as fort law and contract recognized, be given effect, or law. be applied. I. PUBLIC LAW Political Law Branch or department of law Treats of the science of politics or which is concerned with the the organization of government. 1. Constitutional Law  2. Administrative Law Relates to the rights 3. Law of Public Administration - of property and the 4. Law of Public Corporation relations of persons engaged in & 1. Constitutional Law & commerce. Law that relates the 3. Remedial Law constitution, as a permanent & Methods of enforcing system of political and rights or obtaining -juridical government, as redress (correcting distinguished from statutory the wrong) and common law, which relate to matters subordinate THE GOOD SAMARITAN LAW to such constitution. A nurse, therefore, who renders first - aid or treatment at the scene of an - 2. Administrative Law emergency and who does so within The body of rules and the standard of care,& acting in good regulations and orders and faith, is relieved of the consequences decisions created administrative agencies of by - of the act. - government. LAWSUIT Fixes the organization and Proceeding in the court of law for a & - determines the competence purpose. of the authorities which 1. Enforce a right & execute the law, and 2. Redress a wrong - indicates to the individual set right ↳ the remedies for the violation PARTIES TO A CASE of his rights. 1. Complainant vs Defendant - Civil Case - 3. Law of Public Administration 2. Plaintiff vs Accused - Deals with the organization - Crimincal Case and management of the - - different branches of the - WITNESS government. - An individual held upon to give necessary details either for the - II. PRIVATE LAW accused or against the accused. Law that relates the private matters which do not concern the public at STATUTE OF LIMITATIONS & large. - - Refers to the length of time following - Punishment: damages the event during which the plaintiff in Ind P 1. Civil Law - Exident may file a suit.. - Organizing the family - and regulating DUE PROCESS & property. A fair and orderly process which - - - 2. Commercial Law aims to protect and enforce a person’s right. FUNDAMENTAL REQUIREMENTS OF Legal notes from court DUE PROCESS 2. Subpoena 1. Right to be informed An order in court 2. Right to remain silent a. Duces tecum (papers) 3. Right to competent counsel Bring * 4. No use of violence, threat, torture documents, 5. Right to know the witness face to objects, face. materials, chart to court CIVIL JUDICIAL PROCESS b. Ad testificandum A set of interrelated procedures and - (person) roles - for deciding disputes by an Testify as - authoritative person or persons witness at a whose decisions are regularly specified time obeyed. and place The disputes are to be decided 3. Summon according to a previously agreed A writ commanding an - upon set of procedures and in authorized person to notify a - conformity with prescribed rules. party to appear in court to - 1. Filing of a document or complaint answer a complaint made Accuser; complainant; against him. plaintiff; appellee 4. Warrant 2. Answer through reply or response A writing from a competent - Accused; respondent; authority in pursuance of defendant; appellant law, directing the doing of an - & 3. Discovery act addressed to a person Pre-trial activities competent to do it. Determination of probable cause TYPES OF WARRANT 4. Trial 1. Warrant of arrest - Presentation of evidences A court order to arrest or and testimonies detain a person Perjury: lying under oath - - 2. Search warrant Exhibit: once the patient’s A court order to search for & - - chart was used as evidence in - properties a court proceeding Sub judice rule: prohibitions LEGAL CONCEPTS AND ISSUES IN - - in public discussion of a case NURSING - 5. Judgment ↳ WHAT IS FINES? - In Philippines: Judge In USA: Jury refers to monetary charges imposed - upon individuals who have been & WRITTEN ORDERS OF COURT convicted for a crime or a lesser 1. Writ offense. specified by the law - - - WHAT IS DAMAGES? imposed for pecuniary loss but its refer to the pecuniary compensation, amount cannot be provided with - recompense, or satisfaction for an certainty. injury sustained. refer to the pecuniary consequences Nominal Damages which the law imposes for the breach Adjudicated in order that a right of of some duty or the violation of some the plaintiff, which has been violated right. or invaded by the defendant, may be 1. Actual or Compensatory vindicated or recognized, and not for damages the purpose of indemnifying the 2. Moral damages plaintiff for any loss suffered by him. 3. Exemplary or Corrective damages PRIVATE LAW OR CIVIL LAW 4. Liquidated damages I. Tort Law 5. Temperate or Moderate A. Intentional Torts damages B. Unintentional Torts 6. Nominal damages II. Contract Law Actual Damages I. TORT LAW also known as compensatory A legal wrong, committed damages -- against a person or property refer to pecuniary loss suffered by a independent of a contract party as he has duly proved. which renders the person They cannot granted unless who commits it liable for supported by the evidence on record. damages in a civil action. A person who has been Moral Damages wronged seeks compensation include physical suffering, mental for the injury or wrong he anguish, fright, serious anxiety, has suffered from the wrong besmirched reputation, wounded doer. feelings, moral shock, social humiliation, and similar injury. A. INTENTIONAL TORTS There is no hard and fast rule in the A nurse may be held liable determination of what would be a for intentional wrongs: fair amount or moral damages. ○ (+) intent ○ (-) harm Exemplary or Corrective Damages Examples: imposed, by way of example or 1. Assault and Battery correction for the public good. 2. Defamation of Character Liquidated Damages 3. False Imprisonment refers to those agreed upon by 4. Invasion of Right to parties in case of breach of contract. Privacy and Breach of Confidentiality Temperate or Moderate Damages NURSING LEADERSHIP AND MANAGEMENT cont.. USE OF RESTRAINTS ➔ Restraints should be used with caution Assault and Battery and discretion. A. Assault ➔ All patients should have the right to ➔ Unjustifiable attempt to touch another independence and freedom of person or even the threat of doing so. movement. B. Battery ➔ Restraints require a physician's order. ➔ The actual carrying out of the threatened ➔ If a patient or his legal guardian refuses physical contact. to be restrained, this should be Defamation of Character documented in the patient's medical ➔ Occurs where a person discusses another record. individual in terms that diminish reputation. Invasion of Right to Privacy and Breach of A. Libel Confidentiality ➔ Written defamation in words, cartoons ➔ The right to privacy is the right to be left or such representations that cause a alone, the right to be free from person to be avoided, ridiculed or held unwarranted publicity and exposure to in contempt or tend to injure him in his public view as well as the right to live work. one's life without having anyone's name, B. Slander picture or private affairs made public ➔ Oral defamation of a person by speaking against one's will. unprivileged or false words by which his reputation is damaged. Invasion of Right to Privacy and Breach of Confidentiality (cont.) False Imprisonment May be divulged: ➔ It is making someone 1. If the patient allows such revelation wrongfully feel that he or she 2. If communicable disease: inform cannot leave the place. appropriate healthcare agency (DOH) ➔ The unjustifiable detention of a 3. If medico-legal case: inform social person without a legal warrant service department within boundaries fixed by the 4, If given to all healthcare team defendant by an act or violation involved of duty intended to result in such confinement. B. UNINTENTIONAL TORTS A nurse may be held liable for unintentional A. Right to refuse treatment (Autonomy) wrongs: ➔ Sign the waiver of responsibility ( -) intent (freedom from liability) (+) harm ➔ Against Medical Advise (AMA) Examples ➔ Absence Without Authority (AWA) 1. Negligence B. Utilitarianism 2. Malpractice ➔ Greatest good for the greatest number of 3. Incompetence people Negligence ➔ Failure to do something which a CIVIL CODE, ARTICLE 19: reasonable and prudent person should NEGLIGENCE have done. ➔ One shall act with justice, give every man his due, observe honesty and good A. As a crime /culpa criminal) faith. ➔ Felony committed by culpa or fault due ➔ Those who, in the performance of their to imprudence (lack of skills) and obligations through negligence cause negligence (lack of foresight). any injury to another, are liable for damages. B. As torts /culpa contractual) 1. Malfeasance EXAMPLES OF NEGLIGENCE - Performance of an act which ought not 1. Burns to be done. 2. Objects left inside the patient's body 2. Misfeasance 3. Falls of elderly - Improper performance of some act 4. Falls of children which might lawfully be done. 5. Failure to observe and take 3. Nonfeasance appropriate action as needed - Omission of some act which ought to be performed. SPECIFIC EXAMPLES OF NEGLIGENCE 1. Failure to report observations to attending physicians C. As quasi delict (culpa aquiliana) 2. Failure to exercise the degree of ➔ No pre-existing contractual relations diligence which the circumstances of the ➔ Lack of due care particular case demands 3. Mistaken identity TYPES OF NEGLIGENCE 4. Wrong medicine, wrong 1. Commission concentration, wrong route, wrong dose ➔ Wrongdoing 2. Omission LEGAL DEFENSE IN NEGLIGENCE ➔ Total neglect of care ➔ The most common defense in a ➔ Did not do anything negligent action is when nurses know and attain that standard of care in giving ELEMENTS OF NEGLIGENCE service and that they have documented 1. Existence of a duty on the part of the the care they give in a concise and person charged to use due care under accurate manner. circumstances. ➔ If the patient's careless conduct Failure to meet the standard of due care. contributes to his own injury, the patient 3. The foreseeability of harm resulting cannot bring suit against the nurse. from failure to meet the standard. 4. The fact that the breach of this standard resulted in an injury to the plaintiff.