Prepared by: GIANNE T.

GREGORIO
 Introduction
 Types of Law
 Tort law
 Components of
Malpractice
 Elements of Negligence
 Nurses’ responsibilities
 References
 The legal implications of nursing practice are
tied to licensure, state and federal laws,
scope of practice and a public expectation
that nurses practice at a high professional
standard. The nurse’s education, license and
nursing standard provide the framework by
which nurses are expected to practice.
When a nurse’s practice falls below
standards of acceptable
exposes the nurse to and competence, this
care
litigation.
o Address conduct harmful to another individual
or society.
o May be punishable by fines or imprisonment.

o Act prohibited by statute, common law

principles.

o Deals with rights and duties of private person.

 - civil wrong committed against
person
a or person’s property

o Malpractice/Professional
Negligence
o Negligence
 - occurs when a nurse fails to
competently perform his or her medical
duties and that failure harms the patient.
– results from injury that is
unintentional due to failure to take the usual
precautions expected or the legal standards
of care.
• Nurse has a duty. n injury occurred
• Nurse fails to follow
the set standards. within the
• Actual harm or readth of duty of
injury
occurs. the nurse where
• Failure to act ause of injury in the
according
to standards failure to perform
caused the injury. the
uty
 – It is an obligation created either by law or
contract or by any voluntary action. It is the first
element that must be proven, as it arises from the
nurse-client relationship.
– It occurs when a HCP fails to act in
accordance with the standards of care; an act of
commission or omission of the care giver may
constitute a breach of the standards of care.
– Physical, financial or emotional harm must be
demonstrated by person making the claim to prove
negligence.
– It is the breach of duty which is proven to
have legally caused the injury
 A patientundergoing surgery is given an
anesthetic which, due to a previous
treatment, poses an increased risk of use.
As a result of using the anesthetic, the
patient suffers liver damage and dies.
In this case all three elements are present - injury, negligence and
cause. Had the patient not died and perhaps recovered quickly, there
would be no damages for which to sue, despite the fact that the
doctor negligently administered anesthesia.
 A patient suffering deep vein thrombosis (a
blood clot in the deep vein of the leg) goes to
see his doctor about some pain and swelling in
his leg. The doctor misdiagnoses the
symptoms as a simple leg cramp. One week
later, the blood clot is dislodged leading to a
pulmonary embolism and death of the
patient.
Again, the doctor’s failure to diagnose the patient’s illness
correctly led to an otherwise avoidable death, for which the
doctor can be held accountable.
A patient suffering abdominal pain is taken
to the emergency room. The doctor fails to
diagnose appendicitis and sends the patient
home. After several hours, the patient goes
into shock and dies.

The doctors failure to recognize the signs of appendicitis and

act appropriately was a direct cause of the patient’s death,
and could lead to a medical malpractice lawsuit.
A nurse will be liable for malpractice if he
or she injures a patient with a piece of
medical equipment. This can happen in a
variety of ways, like knocking something
heavy onto the patient, burning the
patient, or leaving a sponge inside the
patient after surgery.
 Administering medication according to the
doctor's orders is a common nursing task. If
the nurse fails to follow the orders, she or
he will be liable for malpractice if the
patient is injured. The nurse may also be
liable for negligently following otherwise
proper orders, like injecting a medication
into muscle instead of a vein or injecting
the wrong patient.
Doctrine of – “The thing speaks for itself”
3 conditions required to establish a
defendant’s negligence without providing
specific conduct:
 The injury was of such nature that it
would
normally occur unless there was a negligent act
on the part of someone.
 The injury was caused by an agency within
control of defendant.
 The plaintiff (injured party) himself did not
engaged in any manner that would bring about
the injury.
Doctrine – “Irresistible
ofone that is unforeseenforce”
or inevitable. No
person shall be held responsible for those
events that cannot be foreseen, or which
though foreseen, are inevitable, except in
cases expressly specified by law. Failure to
provide service during circumstances such as
flood, fire, earthquake is considered
negligence.
Doctrine of – “Let the
master answer” Captain of the ship
approach, shared responsibility of employee
& employer.

The liability is expanded to include the

master as well as the employee and not a
shift of liability from the subordinate to the
master.
 INFORMATION CONSENT
Presentation: Competence:
Disclosure to the person This is the ability of the
must be in person to receive the
understandable works information, remember, urrent Medical Status
and manner. understand and assess and general course
it.
of illness.
isks and benefits of
FREE proposed
•FREE (Competent)
•INFORMED (Disclosure) treatment.
•Right to refuse
•Staff nurse as WITNESS
lternatives to
•Physician’s legal responsibility to secure proposed
informed consent from the patient treatment.
•GUARDIANSHIP
•PSYCHIATRIC PATIENT roposed
treatment
 A process to provide adequate
information for the patient or
disclose in a reasonable patient’s
legal representative to make an
informed decision on the proposed
treatment, including medications,
moderate to deep sedation or
procedure.
The nature of the
patient’s
condition.
The proposed treatment, possible
treatment alternatives, including
no treatment.
The benefits of the proposed
procedure, as well as frequently
occurring & significant risks of
the proposed treatment &
possible problems related to
recovery.
If applicable, the possible use in
education &/or research of blood or
tissue removed from the patient
The individuals will be providing
treatment and the role of
everyone providing the proposed
treatment.
The patient or patient’s legal
representative should be given
the opportunity to ask questions
& receive additional information
as requested.
The patient should also be
advised that it is not possible to
predict or guarantee results.
 In an emergency situation
MDEICAL when patient is
EMERGENCY incapacitated, consent
Consent should be obtained from
should be signed by two(2)
father/mother/brother/sister/husband/ Specialists.
wife/legal guardian. Document proof
should be secured to prove
relationship.

PATIENT’
MINOR S LACK
OF
CAPACITY

In these cases, suitable alternative

procedures, including use of legal
guardian & surrogates where
appropriate , should be initiated if
no emergency exists.
Who will take
the consent Me, your treating
from me? physician/
(Patient) anesthesiolgist. I will
also provide education
regarding risks, benefits
& alternatives of
anesthesia including
post op analgesia.

And as you Nurse,

I will sign as
WITNESS. 
 INFORMED CONSENT FOR SURGICAL
PROCEDURE
 INFORMED CONSENT FOR
ANESTHESIA
 INFORMED CONSENT FOR BLOOD
TRANSFUSION
 INFORMED CONSENT FOR
HEMODIALYSIS
 INFORMED CONSENT FOR PERITONEAL
HEMODIALYSIS
 TYPE OF CONSENT AUTHORIZED TO SIGN DURATION
OF
CONSENT
SURGICAL PROCEDURE Legal age is 18 per procedure
the patient is competent
ANESTHESIA CONSENT legal guardian and per surgery
surrogates
BLOOD TRANSFUSION Below 18, 1 year for sicklier
father, mother, brother, 1 month
sister, husband/wife or the
minor’s legal guardian
HEMODIALYSIS 2 consultants or if not initial only and its
available two specialist continuing in the
course of treatment
PERITONEAL initial only and its
HEMODIALYSI continuing in the
S course of treatment
HIGH RISK CONSENT 2 consultants or if not available per surgery
two specialist
 is a statement
that describes a minimum, competent level
of clinical nursing practice care to be
provided to patient/families.

PURPOSE:

To provide nurses with nursing standards

of patient care
The department of Nursing Service shall
develop nursing policies and procedures
that will guide the nurses, assistant
nurses and midwives in providing
nursing care to patients according to
MOH policies and procedure in
implementing rules and regulations.
 Nursing care will be provided by nursing
staff that are competent to fulfill their
assigned responsibilities.
Each patient will:
 Be assessed for physical, functional.
Psychosocial, nutritional, neglect risk, &
discharge care needs.
 Be provided by nursing care based on the
patient’s needs and physician’s diagnosis.
 Have a plan of care that individualized
interventions and reflects recognized standards of
care as well as respect for patient’s rights.
 Each patient will have nursing care/interventions available to meet
his/her needs. Each patient will receive:

 Individualized care based on identified needs.

 Age appropriate Nursing Care/interventions.
 Education in respect to the patient’s health care needs/state.
 Nursing care/interventions designed to meet the
patient’s/families actual and potential post-discharge care
needs.
 Nursing care/interventions designed to promote skin integrity.
 Nursing care/interventions in effective manner, give the
current state knowledge in order achieve the desired outcome
for the patient.
 Nursing care/interventions designed to promote Infection
Control to prevent Nosocomial Infection.
 Commitment to patient and family
rights.
 The patient/family will be involve in his/her
care decision when appropriate.
 Protect the rights of the patient and their families
in the health care process.
 The patient/family’s personal privacy will be
maintained, as well as confidentiality of the
medical record.
 The patient’s as well the families’ psychosocial,
socioeconomic value or state related to health
and treatment are incorporated with the plan of
care.
 Nurses, assistant nurses & midwives
provide consistent, individualized, quality
nursing care to patients regardless their
differences with the aid of the standards
established in the policy.
 Nursing Administration including Charge
Nurse and Supervisors, to safeguard
patient and family rights, being staff and
patient advocate.
  Falls
 Patient
Identification
Helps
Apply 7 rights of medication decrease risk of
administration: bad outcomes
 Right patient
 Right medication Attentive
 Right Dose/Rate listening
 Right Time Accurate
 Right documentation
Documentation and reporting
 Right response
 https://www.ncchc.org/cnp-ethical-legal
 https://www.slideshare.net/ParveenKumarCh

adha1/legal-issues-in-nursing-
practice?from_action=save
 Carl E. Balita Ultimate Learning Guide
2nd Edition
 Informed Consent (PFR 003 - V02)
 NSPP NR 003