Chapter 23Legal Implications in

Nursing Practice

Legal Limits of Nursing Sources of law:

Legal guidelines that come from statutory, regulatory, and common law

Standards of care:Legal guidelines for defining nursing

practice and identifying the minimum acceptable nursing care

Federal Statutory Issues in Nursing Practice

American with Disabilities Act

Emergency Medical Treatment and

Active Labor ActMental Health Parity

ActAdvance Directives

Living Wills, Durable Power of Attorney

Uniform Anatomical Gift Act

Health Insurance Portability and

Accountability Act

Restraints

State Statutory Issues in Nursing Practice

Licensure Good Samaritan laws Public health laws The Uniform Determination of Death

Act Physician-assisted suicide

Civil and Common Law Issues in Nursing Practice

Torts Intentional:

Assault, battery, false imprisonment Quasi-intentional:

Invasion of privacy, malice, slander, libel Unintentional:

Negligence, malpractice

Consent A signed form required for all routine

treatment, hazardous procedures, and some other treatments

Provisions are made for deaf, illiterate, or foreign language clients

Abortion Issues 1973 Roe v. Wade

U.S. Supreme Court ruled that there is a fundamental right to privacy, which includes a woman’s right to have an abortion.

1989 Webster v. Reproductive Health ServicesSome states require viability tests if the

fetus is more than 28 weeks’ gestational age.

Nursing Students You are liable if your actions cause

harm to clients, as is your instructor, hospital, and college/university.

You are expected to perform as a professional when rendering care.

You must separate your student nurse role from your work as a CNA.

Malpractice Insurance A contract between the nurse and the

insurance company Provides a defense when a nurse is

in a lawsuit involving negligence or malpractice insurance

Nurses covered by institution’s insurance while working

Abandonment and Assignment Issues

Short staffing:Legal problems occur if there are

inadequate nurses to provide care. Floating:

Based on census load and client acuities

Physician’s orders:Nurses follow orders unless they believe

an order is in error or harmful.

Risk Management A system of ensuring appropriate

nursing care that attempts to identify potential hazards and eliminate them before harm occurs

Steps involved: Identify possible risks.Analyze risks.Act to reduce risks.Evaluate steps taken.