legal responsibilites of the nurse

8/10/2019 Legal Responsibilites of the Nurse

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LEGAL RESPONSIBILITES OF THE NURSE

DEFINITION OF TERMS:

Legal Rightsa claim that can be enforced by

legal means against the persons or the

community whose duty is to respect it.

Accountabilitybeing answerable when

carrying out professional responsibilities

Liabilitybeing legally bound

Responsibility - an obligation to perform some

act for which one can be held responsible

PATIENTS RIGHTS

Nurses are the advocates of the patients. They

take appropriate steps to safeguard the

patients rights and privileges

Guidelines

1. Nurses shall respect the following rights

when rendering care:

a. cultural and religious beliefs

b. privacy, and

c. confidentiality of information

2. Nurses shall provide the patients all pertinent

information except those which may be

deemed harmful to their well-being.

3. They shall ensure that patients records are

available only to those who are professionally

and directly involved in their care except when

required by law.

4. When conflict arises regarding managementof patient care, the patients rights are upheld.

PATIENTS BILL OF RIGHTS

1. to considerate and respectful care.

2. to obtain from his doctor complete current

info about his diagnosis, treatment and

prognosis in terms that the patient or the

person in his behalf can understand.

3. to make decisions about the plan of care

prior to and during course of the treatment and

to refuse treatment and to be informed the

consequences of this action.

4. to have an advance directive concerning

treatment or designating a surrogate decision-

maker.

5. To every consideration of his privacy.

6. to expect all communication and records

pertaining his care should be treated

confidential.

7. To review the records pertaining to his careand have them explained or interpreted as

needed.

8. to expect response to the request for

appropriate and medically indicated care and

services

9. to ask and be informed of the existence of

business relationship among hospital,

educational institutions, other health care

providers that may influence the patientstreatment and care.

10. to consent or refuse participation in

research studies or human experimentation.

11. to expect continuity of care and to be

informed of available and realistic care options

when hospital care is no longer appropriate.

12. to be informed of hospital policies and

practices that relate to patient care, treatment

and responsibilities

IMPLEMENTING MEDICAL ORDERS

Republic Act 6675 states that only validly

registered medical, dental and veterinary

practitioners, whether in private


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institution/corporation or in the

government, are authorized to prescribe

drugs.

prescription made by unauthorized persons is

punishable under R.A. 2382 (Medical Act of

1959), R.A. 4419 (Dental Act), & R.A. 382

(Veterinary Act)

In accordance with R.A. 5921 (Pharmacy

Act), all prescriptions must contain the

following information:

a.

name of the prescriber

b.

office address

c.

professional registration

number

d.

professional tax receipt number

e.

patients name, age and sex

f.

date of prescription

R.A. 6675requires that drugs be written in their

generic names

RESPONSIBILITIES OF THE NURSE REGARDING

MEDICAL ORDER:

Carry out doctors order, provided that they

are written legal order of the physician andbear the doctors signature

Help plan and implement patient care

Reports patients condition including results

of therapies to properly monitor and modify

the management of care.

Written orders must be clear, specific,

complete and legible in order to minimize

errors.

MANAGING THE OMITTED OR REFUSED

DRUG

Omitted Drugs. Drugs may be omitted

intentionally for the following reasons:

a.The patient is to have a diagnostic test

and is to fast prior to the test. Oral drugs

are usually omitted or their administration

is delayed, depending on the physicians

wishes.

b. The problem for which the medication no

longer exists.

c. The patient is suspected of having allergy

to the medication. Any suspected allergyshould be reported to the physician.

Refused Drug. The responsibilities of the

nurse to take during refusal to take

medication are the following:

a. Report promptly to the physician

b. Note properly in the patients chart

regarding the refusal.

*The nurse play an important role in

determining the reason for the refusal and

to clarify any misconceptions.

Patients have the right to refuse therapy,

and the nurse should recognize and respect

that right.

*BON 08

INTRAVENOUS THERAPY AND LEGAL

IMPLICATIONS Philippine Nursing Act 1991 Sec. 28states

that in the administration of intravenous

injections, special training shall be required

according to protocol established.

Nurses should use the Intravenous Nursing

Standards of Practice developed by the

Association of Nursing Service

Administrations of the Philippines (ANSAP)

TELEPHONE ORDERS

Done only in extreme emergency cases and

when no other resident or intern is

available should a nurse receive telephone

orders.

Such order should be signed by the

physician on his/her next visit within 24

hours.


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The nurse should sign the name of physician

per her own and note the time the order

was received.

REFERRALS: the process of sending or guidingsomeone to another source for assistance.

- a patient may be referred by a hospital to a

community-health nursing service for assistance

with home care.

- a school nurse may refer a student to a

hospital emergency room.

- a referral may be used within a particular

agency. Example: a hospital out-patient clinic

may refer a patient to the hospitals in-servicefacilities.

- most institutions have policies related to

referrals. Policies usually indicate who may

initiate a referral & how it is to be done.

CARRYING OUT A PHYSICIANS ORDER

Only when the orders concerning treatment

and medications are in writing and bear theMDs signaturedoes the nurse have the

legal right to follow it.

It is expected that nurses know basic

information about procedures and

medications ordered by the physician

It is the responsibility of the nurse to clarify

ambiguous or seemingly erroneous orders

from the prescribing MD and/then to other

sources.

THE ORDERS THAT NURSES MUST QUESTIONTO PROTECT THEMSELVES LEGALLY

Question any order the patient questions.

Question any order if the patients

condition has changed.

Question and record verbal orders to avoid

miscommunications.

Question standing orders especially if the

nurse is inexperienced.

IMPLEMENTING DELEGATED AND

INDEPENDENT NURSING INTERVENTIONS

Identify patients before initiatinginterventions.

Protect patients from falls and preventable

injuries.

Documents all nursing assessments and

interventions accurately.

Ask for assistance and supervision in

situations for which you feel inadequately

prepared.

Delegate tasks to persons with the

knowledge and skill to carry them out.

Build and maintain good rapport with

patients

DAMA (Discharged Against Medical Advised)

The right to refuse treatment includes the

right to leave the hospital against medical

advice.

Recognize a potential patient walk-out.

If the patient insist on leaving.

Follow the policy of the hospital regarding

DAMA

If the hospital doesnt have a policy about

DAMA:

1. Contact the patients SO and explain.

2. Explain the hospitals DAMA

procedure to the patient.

3. Give the client a DAMA form and ask

patient to sign.

4. Provide routine discharge care.

Dealing with an escape

Notify the nursing supervisor and security

immediately.

Notify patients family.


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Collect patients belongings and document

it.

CONSENT TO MEDICAL AND SURGICAL

PROCEDURES

Definition: free and rational act that

presupposes knowledge of the thing to

which consent is being given by a person

who is legally capable to give consent.

Only in case of emergencywhere the

consent requirement does not apply.

The physician should give as much

information about contemplated procedure

and the patient should receive enough

information to allow him to give aninformed consent for such procedure.

ESSENTIAL ELEMETS OF AN INFORMED

CONSENT

INFORMATION SHOULD INCLUDE: