Question

Legal Implications in Nursing Practice

You are working the first shift on the hematology-oncology unit and receive report on your assigned team of three patients. You have a nursing assistive personnel (NAP) assigned to help you with routine care. You make quick rounds on your patients to ensure that there are no immediate needs before you begin checking medications. Patient No. 1 is scheduled for surgery later in the morning for a biopsy and needs the surgical consent signed. Patient No. 2 is receiving blood products for a human immunodeficiency virus (HIV) complication and needs frequent vital sign monitoring. You find patient No. 3, an 83-year-old confused man, lying on the floor. He states that he needed to go to the restroom and no one was there to help.

1. The nurse prepares the surgical consent form for patient No. 1. Which key points does he or she need to ensure that the patient received before witnessing informed consent?

2. The son of patient No. 2 calls to talk to the nurse caring for his father. The son asks questions about the reason for the blood administration. Which guidelines does the nurse follow in responding to the son's questions about the father's condition? Which federal statutes are involved in this scenario?

3. One week after discharge from the hospital, the hospital received a written complaint from the family of patient No. 3 about the incident related to the fall and the intent to take legal action.

a. What must patient No. 3 establish to prove negligence against the nurse?

b. Describe situations in which restraints may be applied legally to prevent fall

Answer 1

1.Patient's autonomous decision about whether to undergo a surgical procedure , based on the nature of conditions , the treatment options, and the risks and benefits involved is called informed consent.

For signing a consent a patient must be 18 years or older , mentally and legally fit to give or refuse consent. The nurse's have to sign a witness consent stating that the patient voluntarily gave consent, the patient's signature is legal, and the patient appears to be mentally and legally fit to give consent. The nurse should ask the patient if he or she understands the procedure before that the physician is responsible to explain the procedure to the patient.

Key responsibilities :

• Informed consent should be in writing.
• The physician should have explained about procedure and its complications
• The patient should be allowed to ask questions freely about the procedure and also when patient has a doubt about alternative treatments a second opinion can be sought.
• Patient should be informed that they have full authority to withdraw consent at any time.
• State regulations and any policies in the particular hospital should be followed.
• Refusing to undergo surgery is a patient's legal right.

2. Nurses need to be aware of the confidential nature of any information obtained in daily practice. Disclosing any information without patient consent is maleficence.

• The nurse has the responsibility to check the patient's medical record for a release form indicating with whom medical information can be shared as she is responsible in maintaining patient privacy.  The Americans with Disabilities Act (ADA) is the federal statute that regulates the privacy of patients with human immunodeficiency virus (HIV). Nurses are responsible for protecting patient's right to privacy by safeguarding confidential information .
• The HIPAA is a federal statute which has framed a policy that patients right to consent to use or disclose protected health information. The nurse cannot disclose any details regarding the father until his father gives consent that his protected health information can be released.

3.

a. To prove negligence,the patient should provide a record that the nurse (defendant) owed a duty to the patient (plaintiff), and the nurse failed to attend the patient(breach of duty), the patient has sustained injuries(cause ), and the nurse's failure to do the duty caused the injury(damages).
b. According to The Joint Commission on Accreditation of Healthcare organisations,they have designed a standard for use in care of patients with restraints. Restraints are applied for ensuring the physical safety of the patient or other patients and every hour the nurse should monitor the restraints of patient ,to ensure that patient is safe.