NU 450 lecture 5 Legal Protection in Nursing Practice.pdf

Legal Protection in Nursing Practice Laws Designed to Protect Health Care Providers Legal Aspects and Ethical Issues in Profession (NUR450) 1st semester, 1446H  Outlines 1. Good Samaritan Act 2. Actions to be taken to Protect against Liability 3...

Legal Protection in Nursing Practice Laws Designed to Protect Health Care Providers Legal Aspects and Ethical Issues in Profession (NUR450) 1st semester, 1446H  Outlines 1. Good Samaritan Act 2. Actions to be taken to Protect against Liability 3. Providing Competent Nursing Care 4. Care in Carrying out Physician’s Order 5. Record keeping and Documentation Incident/Occurrence/Variance Reports 6. Integrity of Electronic Documentation 7. Professional Liability Insurance Scenario Sarah, a nursing student, is walking through a park when she notices an elderly man collapse on the ground. He appears to be having trouble breathing. Without hesitation, Sarah runs over, checks for a pulse, and begins CPR while someone else calls for an ambulance. She stays with the man, continuing CPR until paramedics arrive and take over. Later, Sarah worries whether she could be sued if her actions caused harm. “What do you think?” Liability The state of being legally responsible for something. Types of Libility Vicarious Personal Vicarious Liability Vicarious liability describes the instance in which one party is responsible for the actions of another. It is not a shift in liability, but an extension of liability. Respondeat superior :Let the master respond” is the common-law principle of substituted liability based on a master–servant relationship. Corporate Liability Doctrine Corporate liability holds the institution liable for its responsibilities to patients. Corporations must ensure that competent and qualified practitioners deliver quality health care to consumers. Personal Liability Makes each individual responsible for his or her own actions One cannot negate one’s responsibility merely because a second or third party also has responsibility. Neither will the law impose liability on the competent practitioner. Defenses against Liability Defenses are “arguments in support of or used for justification.” Defenses used in relation to intentional, and nonintentional, torts are divided into broad categories, which may overlap. Defenses against intentional torts Defenses against intentional torts generally include: Consent Self-defense and defense of others Necessity Consent Consent may be oral, implied by law, or apparent. Consent may also be implied by law in emergency settings, when person is not capable of either giving or denying consent: There is no reason to believe that A reasonable person in the same or An immediate decision is required The person is incapable of giving or consent would not be given if the similar circumstances would give to prevent loss of life or limb. denying consent. patient were capable of such. consent. Self-Defense and Defense of Others For example, a patient suddenly becomes combative, and there is imminent danger to the nursing Self-defense and defense of others staff, other patients, and visitors. may be justifiable to protect oneself The nurses would be justified in and others in the area from harm. forcibly restraining the patient, even though no order for restraints had been obtained.  Necessity , which is similar to self-defense, allows the nurse to interfere with the patient’s property rights to avoid threatened injury. Necessity For example, imagine that the suddenly combative patient approaches the staff with a knife or attempts to use a belt to strangle the nurse. This defense allows the nurse to take the knife or belt away from the patient. Defenses against Nonintentional Torts Release May be signed during the process of settling a claim to prevent any and all future claims arising from the same incident Exculpatory contracts Exculpatory agreements Defenses against Nonintentional Torts Contributory negligence and comparative negligence hold injured parties accountable for their fault in the injury Contributory negligence rule Pure comparative negligence Modified comparative negligence Defenses against Nonintentional Torts Assumption of the risk Plaintiffs partially responsible for consequences if they understood the risks involved when they proceeded with the action Unavoidable accident Nothing other than the accident could have caused the person’s injury Defenses against Nonintentional Torts Defense of the fact No indication that health care provider’s actions were the cause of the patient’s injury or untoward outcome Immunity Good Samaritan laws Good Samaritan Laws The Good Samaritan Act is a law designed to protect individuals who offer assistance to others in emergency situations from legal liability. The intent of these laws is to encourage bystanders to help those in need without the fear of being sued if something goes wrong. Good Samaritan as an individual who intervenes to assist another individual without a prior notion of responsibility or promise of compensation. Initial emergency/injury was not caused by the person invoking the defense. Emergency care was not administered in a grossly negligent or reckless manner. It is well known that medical emergencies outside of the umbrella medical setting or clinical environment are common. Key points of the Good Samaritan Act include: Protection from lawsuits: As long as the person offering help acts in good faith, without gross negligence, they are generally shielded from liability if their actions inadvertently cause harm. Emergency situations: The law typically applies to medical emergencies or other urgent situations where immediate help is required. Non-professional rescuers: The protection is primarily intended for bystanders or laypeople who are not medical professionals. Providing Competent Nursing Care Legal Accountability: Nurses are legally required to provide care that meets professional standards. If they fail to meet these standards, they can be held legally accountable for malpractice or negligence, potentially facing lawsuits or loss of licensure. Patient Rights: Laws such as informed consent, confidentiality (like HIPAA), and patient autonomy ensure that nurses respect and uphold patients' legal rights. Providing competent care means understanding and complying with these laws to protect patients. Providing Competent Nursing Care Scope of Practice: Laws define the scope of nursing practice, outlining what tasks and responsibilities nurses can legally perform. Competent care requires nurses to stay within their scope and seek proper authorization or additional training when needed. Documentation: Legal regulations mandate proper documentation of patient care. Accurate, detailed records are essential not only for patient safety, but also as legal evidence of the care provided, protecting both the nurse and the patient. Care in Carrying out Physician’s Order Carrying out a physician’s order with care and understanding its legal implications is essential for nurses to avoid liability and ensure patient safety. Vicarious Liability: Nurses may face legal action if their actions directly cause harm to a patient, even if they were following a physician’s order. Nurses have a duty to exercise their own professional judgment, and blindly following orders that are harmful can lead to liability. Negligence and Malpractice (Failure to adequately assess, monitor, and communicate): A nurse can be held liable for negligence or malpractice if they fail to meet the standard of care expected in their profession. This could occur if they administer medication incorrectly, misinterpret an order, or fail to notify the physician of a patient’s deteriorating condition. Care in Carrying out Physician’s Order Defenses for Nurses: Nurses can protect themselves in lawsuits by demonstrating that they acted in accordance with the standard of care, properly followed physician’s orders, and exercised good judgment. Proper documentation and communication with the healthcare team are critical in defending against claims. Involvement in Informed Consent: Nurses are responsible for ensuring that patients are informed about treatments before they are carried out. While obtaining informed consent is typically the physician’s responsibility, nurses must ensure that patients have the necessary information and are comfortable proceeding. Incident Reports/ Occurrence variance reporting (OVR) An incident report/OVR is a formal written document that serves as a reference when an unexpected event or accident occurs, such as actual and potential injury, damage, or death. The incident report should be initiated by the one who directly observes the incident or by the first person to arrive at the site of the incident. For an incident report to be considered privileged under the attorney–client privilege, it ideally will be completed and forwarded directly to the hospital attorney or the in-house representative. Integrity of Electronic Documentation An electronic health record (EHR) is a record of a patient's medical details (including history, physical examination, investigations and treatment) in digital format. Integrity assures that the data is accurate and has not been changed. Inaccurate representation of the patient's current condition and treatment occurs due to improper use of options such as “cut and paste”. This practice is unacceptable because it increases the risk for patients and liability for clinicians and organizations. Integrity of Electronic Documentation Another feature that can cause a problem in the data integrity is the drop-down menu and disposition of relevant information in the trash. Such menus limit the choices available to the clinician who in a hurry may choose the wrong one leading to major errors. Clinicians and vendors have been working to resolve software problems to make EHRs both user-friendly and accurate. EMR is the most targeted in healthcare breaches. The risk of breaches affects the security or privacy of patient data, the possibility of hacking, destroying the data, incorrect paper to electronic transmission, and error in treating patients. Professional Liability Insurance Professional liability insurance protects nurses against lawsuits that arise from real or alleged errors or omissions, including negligence, in the course of delivering nursing care in clinical settings. Coverage: Provides financial protection against claims of negligence or malpractice. It covers legal costs, settlements, and judgments. Importance: Ensures that nurses are not personally financially liable for legal claims related to their professional activities. References Guido, G. W. (2020). Legal and ethical issues in nursing (Seventh edition). Pearson Education, Inc. Janarthanan, V., Kumaran M, S., Nagrale, N. V., Singh, O. G., & Raj, K. V. (2024). Legal and Ethical Issues Associated With Challenges in the Implementation of the Electronic Medical Record System and Its Current Laws in India. Cureus, 16(3), e56518. https://doi.org/10.7759/cureus.56518 Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in clinical research, 6(2), 73–76. https://doi.org/10.4103/2229-3485.153997