Law and the Professional Nurse

Law and the
Professional Nurse
Chapter 15
Sources of Law
• Statutory law
• Administrative law
• Case law
• Enforcing the law
– Civil
– Criminal
Civil Case Flowchart
Trial setting
Notice of
Appeal and
motion to set
for default
Nursing Scope and Standards
• Nursing scope of practice describes who, what,
where, when, why, and how of nursing
• 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
• Resource utilization
• Environmental health
• Cultural congruence
Standards: State Boards of Nursing
• Develop scope of practice statements for licensure
• Expand scope statements for advanced practice
• Make decisions about new practices and procedures
• Define new categories of licensure, recognition, and
• Determine appropriateness and level of discipline
• Define state accreditation of nursing educational
Evidence of Standards of Care
Used in Court
• Statutes
• Agency regulations
• Accreditation standards
• Facility documents such as policies and procedures, job
• 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
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
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
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

Privacy and Confidentiality
• Privacy is the right of a person to be free from
unwanted intrusion into the person’s personal
• Confidentiality of patient information is the
obligation of all healthcare providers
HIPAA(1 of 2)
• Patients must be informed of their privacy
• 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

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
Model of Professional Nursing
Practice Regulation