prof ad lecture

8/10/2019 Prof Ad Lecture

1/129


2/129

NURSING JURISPRUDENCE

Defined as the department of law thatcomprises all the legal rules and principlesaffecting the practice of nursing.

It deals with: 1.All laws, rules and regulations. 2. Legal principles and doctrines governing

and regulating the practice of nursing. 3. Legal opinions and decisions of

competent authority in cases involvingnursing practice.


3/129

ources o urs ng ur spru ence n ePhilippines:

1. The Constitution of the Republic of the Philippines,particularly the Bill of Rights.

2. Republic Act No. 9173 otherwise known as the PhilippineNursing Law of 2002

3. Rules and regulations promulgated by the Board ofNursing and/or Professional Regulation Commissionpertaining to nursing practice.

4. Decisions of the Board of Nursing and/or ProfessionalRegulation Commission on nursing cases.

5. Decisions of the Supreme Court on matters relevant tonursing.

6. Opinions of the Secretary of Justice in like cases.7. The Revised Penal Code.8. The New Civil Code of the Philippines.9. The Revised Rule of Courts.10. The National Internal Revenue Code as amended


4/129

Types of Law

Civil Law

Civil lawsuits involve personal injuries,

business disputes, land deals, libel andslander, and various other commercialinterests.

Civil law actions must be brought by anattorney hired by the injured party (theplaintiff)against the alleged wrongdoer(the defendant).


5/129

In the NURSING

Profession Civil Liability: the basis is the damage

suffered by the aggrieved party (patient)

on the account of negligence of the

nurse. ; its in the form of payment orcompensation.

Different kinds of damages

1. Actual Damageexpenses incurred bythe patient


6/129

Scenario

Patient underwent surgery, everything

was alright

Nurse mistakenly gave or applied

wrong medicine to patients woundresulting to allergy on the last day of

confinement

Patient had to stay longer*****Expenses on the additional days

of confinement = actual damages


7/129

2. Exemplary damagethose that are

imposed by the court; usually imposed

in cases of gross negligence (

repeatedly giving of wrong medications)

3. Moral Damagescompensates mental

anguish and sufferings,; sleepless nights4. Lost of Income


8/129

Complaint maybe filed in the Municipal Trialcourt if less than P200,000.00 orRegional Trial

Court if patients claim is more than

P200,000.00

Doctrine of Vicarious Liabilityby virtue of employer-employee

relationship . If nurse is not capable ofpaying damages, court may order the

hosp to pay


9/129

The Captain ofthe Ship

Doctrine

wherein the surgeon is

presume to be responsiblefor everything that

happens within the

operating room


10/129

Administrative law

is the body of law that governs the

activities of the administrative agencies.

Administrative law is considered abranch of public law.

deals with the decision-making of

administrative units of government(e.g., taxation, immigration, transport,

manufacturing)


11/129

In the NURSING

ProfessionAdministrative Liability: violation of any

admin law in RA9173.

Filed in the BON under PRC

Purely personal, meaning license ofhosp is not affected by the negligence ofthe nurse

However, the hosp has its own liabilityunder hospital regulations and laws

Either reprimand or penalty


12/129

Criminal law

those dealing with homicide, illegal drugs,theft, and other antisocial behavior--areenforced by agents of the state against

specific persons or corporations.

is designed to protect society as a wholerather than to compensate individuals whohave been victims of criminal activity.


13/129

In the NURSING

Profession Criminal Liabilityincurred by a guilty

nurse having found guilty from homicideresulting from reckless imprudence or

gross negligence

Unlike in a civil liability, neither theCaptain of the ship nor the Doctrine of

Vicarious Liability applies. Complaint filed to the Public Prosecutors

Office


14/129

PRIVATE OR CIVIL LAW

body of law that deals withrelationship among privateindividuals

PUBLIC LAW

body of law for the welfare of thegeneral public; relationshipbetween individuals and thegovernment and government

agencies


15/129

LEGAL RIGHT

a claim which can beenforced by legal meansagainst a person whoseduty is to respect it.

COURTAn agency in the

government wherein the

administration of justiceis delegated.


16/129

COURT MECHANISM

LAWSUIT-proceeding in court

for a purpose.

Purpose:

Enforce a right

Redress a wrong


17/129

STATUTE OF LIMITATIONS

Refers to the length of time following the

event during which the plaintiff may file a

suit.

Example:

negligence- filed within 2-3 years from

occurrence.


18/129

DUE PROCESS

A fair and orderly process which aims toprotect and enforce a persons right.

FUNDAMENTAL REQUIREMENTSOF DUE PROCESS:

1. Right to be informed

2. Right to remain silent3. Right to competent counsel

4. No use of violence, threat, torture

5. Right to know the witness face to face


19/129

PHASES OF DUE

PROCESS PRE-TRIAL- eliminate matters not

in dispute, agree on issues or

settle procedural matters.

TRIAL- facts are presented and

determined; law applied at the

end.

WRITTEN ORDERS OF


20/129

WRITTEN ORDERS OF

COURTWRIT- legal notes from courtSUBPOENA- an order in court

Ducestecum (papers)bringdocuments, objects, materials, chart tocourt

Ad testificandum (person) testify aswitness at a specified time and place

SUMMON- a writ commanding anauthorized person to notify a party toappear in court to answer a complaintmade against him.


21/129

WARRANT- a writing from a competent

authority in pursuance of law, directing

the doing of an act addressed to a person

competent to do itWarrant of arrest- a court order to

arrest or detain a person

Search warrant- a court order to searchfor properties


22/129

LAWS THAT PROMOTE THE

WELFARE AND WELL-BElNG OF

NURSES

P.D. 442- Labor Code

Defines among other things, hours of

work, contract and nurse staffing in

industrial clinics

P.D. 807-Civil Service Law

Provide for the recruitment and

selection of employees in governmentservice; qualification standards;

personnel evaluation system; and

personnel discipline


23/129

R.A. 7305- Magna Carta for Public

Health Workers

Has provisions on benefits, rights and

responsibilities of public healthworkers

R.A. 8344 No Deposit Policy

Prohibits hospitals and clinics from

demanding advance payments/cash

deposits before patients are admitted

or treated


24/129

LEGAL CONCEPTS AND

ISSUES IN NURSING LIABILITY: is an obligation or debt

that can be enforced by law

A person who is liable for malpractice

is usually required to pay fordamages.

DAMAGES: refer to compensation in

money recoverable for a loss of

damage


25/129

PROFESSIONAL

NEGLIGENCE

Negligencefailure to do

something which a

reasonable & prudent

person should have done.

2 types:

1. Commissionwrong

doing

2. Omissiontotal neglect

of caredidnt do anything


26/129

If the patients

careless conduct

contributes to his

own injury, the

patient cannot bring

suit against the

nurse.


27/129

Negligence results from.

Injury that is unintentional due to failure to

take the usual precautions expected or the

legal standards of care.

ELEMENTS OF NEGLIGENCE1. Dutyan obligation

2. Breach of dutyfailed to follow the

standards3. Injuryharm demonstrated by the nurse

4. Causationlegal cause of injury


28/129

SPECIFIC EXAMPLES OF

NEGLIGENCE

1. Failure to report observations to attending

Physicians

2. Failure to exercise the degree of diligence which the

circumstances of the particular case demands3. Mistaken Identity

4. Wrong medicine, wrong concentration, wrong

route, wrong dose

5. Defects in the equipment such as stretchers and

wheelchairs may lead to falls thus injuring the

patients


29/129

Burns resulting from hot water bags,heat lamps, vaporizers, sitz bath

Objects left inside the patients body;

sponges suction tips Falls of the elderly, confused,

unconscious, sedated patients

Falls of children whose bed rails were

not pulled up and locked Mistaken identity- drug given to the

wrong patient

Wrong medicine, wrong concentration,

wrong route, wrong dose Defects in the equipment


30/129

DOCTRINES OF

NEGLIGENCE

1. RES IPSA LOQUITOR

- the things speak for itself

- the injury is enough proof of negligence

A patient came in walking to the out-patientclinic for injection. After injection wasadministered to his buttocks, the patientexperienced extreme pain, leg weakness, and

was subsequently paralyzed. The presence of sponges in the patient's

abdomen after an operation.

Fracture on a newly-delivered baby born by

breech presentation.


31/129

2. RESPONDEAT SUPERIOR

- Let the master answer for the acts ofthe subordinate

- The liability is expanded to include themaster as well as the employee andnot a shift of liability from thesubordinate to the master.


32/129

The hospital will be held liable, if, in an

effort to cut down on expenses it

decides to hire underboard nurses or

midwives in place of professionalnurses, and these persons prove to be

incompetent

The surgeon will be held responsible incase a laparotomy pack is left in a

patients abdomen


33/129

3. FORCE MAJEURE

- Irresistible force; unforeseen orinevitable event- No person shall be responsiblefor those events which cannotbe foreseenEx. Flood, fire, earthquake

INCOMPETENCE: lack of ability,legal qualifications or fitness todischarge the required duty

LIABILITY OF NURSES FOR THE


34/129

LIABILITY OF NURSES FOR THEWORK OF NURSING AIDES

Nursing aides perform selected nursingactivities under the direct supervision ofnurses.

They are usually given on-job-training bythe Training staff.

Their responsibilities usually pertains tothe routine care of chronically ill patients.

They are therefore responsible for their

own actions.


35/129

LIABILITY FOR THE WORK OF

NURSING STUDENTS

Under the Philippine Nursing

Act of 2002 R.A. 9173,nursing students do notperform professional nursing

duties. They are to besupervised by their clinicalinstructors.

GUIDELINES TO AVOID MISTAKES OF


36/129

GUIDELINES TO AVOID MISTAKES OF

NURSING STUDENTS

Nursing students shouldalways be under the

supervision of their clinical

instructors


37/129

They should be advised to seek guidanceespecially if they are performingprocedure for the first time

They should be oriented to the policies ofthe nursing unit where they are assigned

They should be advised to seek guidanceespecially if they are performing

procedure for the first time They should be oriented to the policies of

the nursing unit where they are assigned


38/129

5. Their performance should be assessedfrequently to determine their strengthsand weaknesses

6. Frequent conferences with the studentswill reveal their problems which they maywant to bring to the attention of their

instructors or vice-versa. Discussion ofthese problems will iron out doubts andpossible solutions may be provided.


39/129

LEGAL DEFENSE IN NEGLIGENCE

The most common defense in anegligent action is when nurses knowand attain that standard of care in

giving service and that they havedocumented the care they give in aconcise and accurate manner

If the patients careless conductcontributes to his own injury, thepatient cannot bring suit against thenurse.

MEDICAL ORDERS


40/129

MEDICAL ORDERS,DRUGS, AND

MEDICATIONSR.A. 6675 states that only validly registeredmedical, dental, and veterinary practitioners,whether in private institution/corporation or in the

government, are authorized to prescribe drugs.In accordance with R.A. 5921, or the pharmacy

Act as amended, all prescriptions must contain thefollowing information: name of the prescriber, office

address, professional registration number,professional tax receipt number, patients/clientsname, age, and sex, and date of prescription. R.A.6675 requires that the drugs be written in their

generic names.


41/129

Ruling:

Do not follow unless 3 vital information

given above are present.

1. name of physician,

location of office, PTR/PRC license no.

2. Patients name, age, sex,

3. Name of the drug itself : both generic

and brand name (RA 6675)


42/129

RA 6675 the Generics Act of 1988 whichrequires that all prescriptions of drugs shouldinclude the generic name and the brand nameor the generic name alone.

Purpose : to let the patient choose among thedifferent brand names available of a specificgeneric drug name


43/129

Impossible prescription : areprescriptions written by a doctor in which

the generic and brand names do not

correspond to each other.

Exception to RA 6675 : The physician

can only be allowed to write only the

brand name if only one brand isavailable for the particular drug being

prescribed. Ex. : Alaxan, Minocin


44/129

General Rule : A nurse should neverprescribe any medication nor administer

drugs without a valid doctors order.

Exceptions to the general rule : 1. In case of emergency

2. In cases of national calamity

3. In cases of epidemic PLUS : theres nodoctor around and the patient is in grave

danger of death. Good Samaritan Act


45/129

IV Therapy and Legal Implications

Philippine Nursing Act of 1991 Section 28states that in the administration ofintravenous injection, special

training shall be required accordingto protocol established

Board of Nursing Resolution No. 8

states that without such training and who administersintravenous injections to patients shall be held liableeither criminally under Sec 30 Art. VII of said law oradministratively under sec 21 Art III or both (whethercausing or not an injury or death to the patient)

SCOPE OF DUTIES AND RESPONSIBLITIES IN IV


46/129

SCOPE OF DUTIES AND RESPONSIBLITIES IN IV

THERAPY

1. Interpretation of the doctors orders for IV therapy2. Performance of venipuncture, insertion of

needles, cannulas except TPN and cutdown

3. Preparation, administration, monitoring andtermination of intravenous solutions such as

additives, intravenous medications, and

intravenous push

4. Administration of blood/blood products as ordered

by the physicians


47/129

5. Recognition of solutions and medicine

incompatibilities

6. Maintenance and replacement of sites, tubings,dressings, in accordance with established

procedures

7. Establishment of flow rates of solutions,

medicines, blood and blood components

8. Utilization of thorough knowledge and proficient

technical ability in the use/care, maintenance,

and evaluation of intravenous equipment

9 Nursing management of total


48/129

9. Nursing management of total

parenteral nutrition, out-patient

intravenous care

10. Maintenance of established

infection control and aseptic nursing

interventions

11. Maintenance of appropriate

documentation, associated with the

preparation, administration and

termination of all forms ofintravenous therapy.


49/129

MALPRACTICE

Doing acts or conducts that are not

authorized or licensed or competent

or skilled to perform, resulting to

injuries or non-injuriousconsequences

Stepping beyond ones authority

Negligent act committed in thecourse of professional performance

RN exceeding the scope of nursing

practice & does an MDs job.

ELEMENTS OF


50/129

ELEMENTS OF

MALPRACTICEA. Standard of Care: Failing to assess serious changes

in patient condition, such as

failure to check neurologicalstatus, vital signs, or blood

glucose levels on time.

Failure to take appropriate action

or notify physician when

significant changes of pts..


51/129

If the nurse successfully demonstrates that

he/she has met an acceptable standard

of care, then there is no malpractice.

Remember what your nursing instructors

always used to say, "If you didn't

document it, it didn't happen!" - in otherwords proper documentation can be

your best defense!


52/129

B. Duty

By accepting the assigned patients the

nurse has assumed a duty to treat the

patient with that degree of skill, care,and diligence possessed or exercised by

competent and careful nurses.


53/129

C. Legal Causation

A legal cause of action for negligence

usually exists when it is determined thatthe breach of the standard of care

proximately caused damages, usually

physical or emotional in nature to thevictim.


54/129

D. Damages: Substantial injuries caused bybreach of the standards of care that satisfy the"damages" element of a medical malpracticeclaim include:

Death

Disability

Deformity

Additional hospitalization or surgery to correct amedical error

Severe and prolonged pain


55/129

Telephone Orders and Reports

When reporting via telephone,

the nurse must demonstrate

courtesy and professionalism.

organize information

beforehand to ensure that

reports made by telephone

are brief and clearlyunderstood by the receiver.


56/129

when reporting changes in the client's

condition to the attending physician, it is

prudent for the nurse to review his/her

notes and have assessment data readybefore placing the call.


57/129

The nurse should also document in the

nurses' progress notes the following:

the date and time of the telephone report the name of the physician the nurse spoke

with

the data reported, and any order given bythe physician in relation to the telephone

report accomplished by the nurse.


58/129

Things to consider:

Telephone orders should be brief andthe person receiving it should read theorder to the physician verbatim.

When taking medication orders, thenurse should spell the name of the drugto the physician to avoid errors.

The use of abbreviations such as "U"

for units and "mcg" for micrograms isalso avoided.


59/129

the nurse should accomplish the following:record the date and time the order was given

and write the order as dictated by the

physician. The nurse also signs the order beginning

with at.o.(telephone order), the physician's

name followed by her (the nurse's) name and

signature and the signature of another nurse

who witnessed the telephone order.


60/129

The nurseshould ensurethat the

physiciancountersignsthe telephone

order within24.


61/129

For physician's orders transmitted via fax,

the order should bear the physician's nameand signature. The nurse should also call

the physician to verify if he or she initiated

the order. The nurse documents the telephone order in

the nurses' progress notes immediately after

the call.

Verbal or telephone order


62/129

Verbal or telephone orderGeneral rule:as possible avoid T.O.

whatever is not written is not an order

Exception:During extreme emergency only!

What to do?

1. Nurse should read back such order to thephysician to make certain the order has beencorrectly written.

2. Such order should be signed by the physician

within 24 hours.3. The nurse should sign the physicians name

per her own and note the time and order wasreceived.


63/129

INTENTIONAL WRONGS

TORTS: A legal wrong, an injurycommitted against a person orproperty

TYPES:

1. Unintentional- do not requireintent but do require the elementof harm.

Ex. Negligence and malpractice


64/129

2. Intentional- the act was done on purposeor with intent; no harm,

injury or damage is needed to be liable.

ASSAULT- an attempt or threat to touchanother person unjustifiably; mental or

physical threatEx.- forcing a pt. to take his medicationor treatment

BATTERY- physical harm through


65/129

p y gwillful touching of person orclothing without consent.

Ex.giving of injection withoutpts consent

FALSE IMPRISONMENT- Unjustifiable detention of aperson without a legal warrant

- occurs when the person is not

allowed to leave a health carefacility when there is no legaljustification to detain the client.


66/129

INVASION OF PRIVACY

Right to privacy is the right to beleft alone

Right to be free from unwarrantedpublicity

Exposure to public view

Divulge information from patientschart to improper sources orunauthorized person


67/129

PRIVILEGED

COMMUNICATION:

Statements uttered in goodfaith; not permitted to be

divulged in court of justice


68/129

Exceptions: Confidentialinformation can berevealed!

Pt. consent, if there is a

Crime, child abuse,Communicable disease-

Ethics


69/129

DEFAMATION

Character assassinationThere must be a third person who

hears or read the comment before it

can be considered defamation

TYPES:

Slander-oral defamationLibel-written words


70/129

RESTRAINTS

Restraints are protective devicesused to limit the physical activity of aclient or to immobilize a client or anextremity.

TYPES: Physical restraints: restrict clients

movement through the application ofa device

e.g. restraint jacket, straps, Chemical restraints: Medications

given to inhibit a specific behavior ormovement.

e.g. sedation, psychotrophic drug


71/129

Points to consider

Restraints are applied only when

absolutely necessary and are used as a

last resort.

Restraints are applied to protect the client

and others from injury.

Restraints are never used as a form ofpunishment or used for the nurse's

convenience.


72/129

Before applying restraint to aclient, know the healthcarefacility's policy on restraints first.

The use of restraints is orderedby a physician and the ordershould be signed, dated, and

should specify the type ofrestraint used and for how long.


73/129

In emergency situations, restraints maybe applied by an authorized andqualified member of the healthcare unit.However, an order should be obtainedfrom a physician within 24 hours.

Ideally, a physician's order should beobtained within the first hour and a

registered nurse should evaluate theneed for continued restraint after the firstfour hours of use.


74/129

Always obtain consent from a competentclient or from the guardian in the case of a

legally incompetent client before the

application of restraint to avoid legalcomplications (the nurse may be charged

with false imprisonment, battery, and lack of

informed consent).

If an ordered restraint is refused by the client

or the guardian, check the policy on

restraints immediately. --- waiver needed.


75/129

Choose a type of restraint appropriate for theclient.

Restraints are applied securely and in such a

way that it can be easily removed in cases ofemergency.

Restraints should support normal anatomic

position of body parts to prevent

complications.


76/129

Ongoing assessments should be performedevery 30 minutes. Watch out for cyanosis,

pallor, broken skin, or coldness.

Restraints should also be removed for 10minutes every 2 hours to provide for ROM

exercises, repositioning, ambulation, and

skin care.


77/129

When restraints are temporarilyremoved, the client is never left

unattended or left with a family member.

If necessary, responsibility should onlybe delegated to an authorized qualified

personnel and never to the client's

family member.


78/129

Proper documentation should beaccomplished.

Documentation should include the rationale

for restraining the client, type of restraintused, explanations given to client and

significant others, client's consent, times

restraint was applied and removed,

alternative to restraints tried, protectivecare rendered, clients responses, and

notification of the physician.

ALTERNATIVES TO


79/129

ALTERNATIVES TO

RESTRAINTS

Before restraints offer explanations,ask someone to stay with the client,use clocks, calendars, TV & radio (todecrease disorientation) or anyrelaxation techniques.

Assign confuse and disorientedclients to rooms near the nursesstation.

Maintain toileting routines & instituteexercise and ambulation schedulesas the client condition allows.

CRIMES & OTHER ACTS


80/129

CRIMES & OTHER ACTS

CRIME: An act committed or

omitted in violation of the law

Two elements:1. Criminal act

2. Evil/criminal intent


81/129

Criminal negligence

Reckless imprudence- person does an

act /failing from to do an act by which

damage results immediately

(imprisonment 1-4 yrs)

Simple imprudence- did not use

precaution and the damage was not

immediate(imprisonment 1-6 months)


82/129

Felony- a public offensecommitted with deceit and fault

Manner of commission:Deceit (dolo) when act is performed

with deliberate intent

Fault (culpa) when the wrongful actresults from imprudent, negligenceor lack of foresight and skills


83/129

ELEMENTS OF A FELONY

1. An act or omission

2. Done voluntarily3. Punishable by law


84/129

Intentional Felonies

Physical injuries,

murder,

parricide,(highest form

of destruction),

infanticide, abortion,

rape, mutilation

Persons liable for the crime


85/129

Principals- are those who take a direct part inthe execution of the act, who directly force orinduce others to commit it;

Accomplices- are those who, not beingprincipals, cooperate in the execution of theoffense by previous and simultaneous act.

Accessories-are those who, having theknowledge of the commission of the crime.

Assisting the offender to profit from the crimeeither by disposing the body, concealing orassisting in escape of the principal of thecrime.

Cl f F l i


86/129

Classes of FeloniesConsummated-when all the elements necessary

for its execution and accomplishment are present.

Frustrated- when the offender performs all the acts orexecution which will produce the felony as aconsequence but which nevertheless, do notproduce it by reason of causes independent of thewill of the perpetrator.

Attempted- when the offender commences thecommission of the same directly by overt acts, anddoes not perform the acts which shall produce thefelony.

Consummated felonies as well as attempted andfrustrated are all punishable by law.


87/129

J E M A A


88/129

J E M A A

Circumstances

affecting criminalliability

JUSTIFYING


89/129

JUSTIFYINGSELF-DEFENSE

These are the defenses in which

the accused is deemed to have

acted in accordance with the lawand therefore the act is lawful.

Since the act is lawful, it follows

that there is no criminal, no

criminal liability and no civilliability


90/129

When he acts in defense of hisrights

When he acts in defense of hisrelatives rights

When he acts in defense of astrangers rights and that the persondefending is not induced by revenge

or evil motives. In order to avoid evil or injury

In a fulfillment of a duty

EXEMPTING


91/129

EXEMPTINGThere is a crime committed but there is no criminal

on account of the absence of a freewill andvoluntariness to act.

Insane

Under 9 y/o

Under compulsion of uncontrollable force or by mere

accident without intentionUnder impulse of uncontrollable fear

Failure to perform an act required by law whenprevented by some lawful cause

MITIGATING


92/129

MITIGATINGLessens the penalty

Under 18y/o or over 70 y/o

No intention to commit so gravea wrong

Voluntary surrender

Deaf & dumb/ with physical defectSuffer from such illness that

diminishes willpower

AGGRAVATING


93/129

AGGRAVATING

Increases the penalty

Treachery/taking advantage of superior strength

or positionPrice, reward

Use of fire, poison, explosion

CalamitiesFraud or disguise employed

Cruelty

ALTERNATIVE


94/129

ALTERNATIVE

May increase/ decrease criminal liabilitydepending on the nature and effects ofthe crime

RelationshipVoluntary surrender

Disguise in being employed

Defense of a stranger

Acts under the impulse of an uncontrollable fear

Offender is insane


95/129

CRIMESCONCERNING

THE NURSE

MORAL TURPITUDE


96/129

MORAL TURPITUDE

Are acts contrary to the accepted and

customary rule of right

1. Rape:

a.) Ordinary rapeforciblepenetration of sex organ to a sexorganb.) Sexual assaultanything forciblyinserted to any orifice.

InterventionSafety (emotional and physical)

Report the incidence

Referral (if the father is the rapist,

ANTI- RAPE LAW (RA 8353)


97/129

( )

R.A. 7877Anti-sexualHarassment Act

1.Any person who

exercises authority

2.Asking sexual favors in

exchange of another

favor

2.MURDER- killing of another withintent


98/129

intent

3. HOMICIDE- unintentional killing

of another person

4. PARRICIDE

Killing of a person to whom you

have a relationship1. father

2. mother

3. brothers/sisters

4. ascendants

5. descendants

6. spouse


99/129

5. ABORTION-termination of

product of conception beforethe age of viability.

6. INFANTICIDE

- the killing of an infant less than

three days or 72 hours.

7. ROBBERY


100/129

8. THEFT- -anyone who gets the personalproperty of another without the latters

permission.

-Anyone who gets thepersonal property of

another with the use

of force, violence orintimidation.

9. SIMULATION OF


101/129

BIRTH

1. Pretend that a woman gave birth2. Substitution or exchanging of babies

in the nursery

3. Intentionally putting wrong

information in the birth registrationform

P.D. 651Birth Registration Act - requiresany person (RN,OB, midwife) who shallassist in giving birth to report within 30days without penalty any live birth at LocalCivil Registrars Office.

10. DISPENSING OF PROHIBITED

DRUGS


102/129

DRUGS

R.A. 6425 (1965)Dangerous DrugsAct

A. Prohibitedchemicals or substances

that are totally and absolutely cant be

consumed by human being.Ex. Shabu, cocaine, cannabis

B. Regulatedcan use this drug - with

appropriate prescription - MD withappropriated license

Ex.- Valium, dormicum

PENALTY FOR


103/129

VIOLATING THE ACT

For licensed health care providers

Fines

Imprisonment

Automaticrevocation of license

GUIDELINES TO PREVENT


104/129

CRIMINAL LIABILITY:

1. Be very familiar with the Philippine Nursing law2. Be familiar with the laws affecting nursing

practice

3. Know agency rules, regulations, policies

4. Upgrade skills and competence5. Develop good IPR with co-workers6. Consult superior as needed7. Verify vague/ erroneous orders8. Always keep doctor updated regarding patient

9. Ensure accurate recording and reporting10. Get informed consent11. Do not delegate responsibilities to others


105/129

Consentis defined as a free and rational act that


106/129

presupposes knowledge of the thing to whichconsent is being given by a person who is legallycapable to give consent

Nature of consent- an authorization by thepatient or a person authorized by the law to give

the consent on the patients behalf. Informed Consent-A written consent should be

signed to show that the procedure is the oneconsented to and that the person understands the

nature of the procedure


107/129

The nurses responsibility inwitnessing the giving of informed

consent involves:

(1) witnessing the exchange b/w the

client and the physician (2)

witnessing the client affix his

signature (3) establishing that the

client really understood.

ESSENTIAL ELEMENTS OFINFORMED CONSENT:


108/129

INFORMED CONSENT:

1. The diagnosis and explanation of the condition2. A fair explanation of the procedures to be done

and used and the consequences

3. A description of alternative treatments orprocedures

4. A description of the benefits to be expected

5. The prognosis, the recommended care,procedure is refused


109/129

Patient must consent in his own

behalf If he is incompetent, or

physically unable, and is not in

emergency case, consent must betaken from another who is

authorized to give it in his own

behalf


110/129

Parents or someone standingin their behalf, gives the

consent to medical or surgical

treatment of a minor. Parentalconsent is not needed if the

patient is married or

emancipated


111/129

A mentally incompetent person

cannot legally consent to

medical or surgical treatment.The consent must be taken

from parents or legal guardian

MENTAL COMPETENCY


112/129

MENTAL COMPETENCY

All patients are presumed tobe competent unless declared incompetent by a

court of law.

Supporting documentation of the patients

behaviors, speech, decision making and physical

and mental status are very useful in establishinghis/her mental competency


113/129

No consent is necessary because inaction

at such time may cause greater injury. Iftime is available and an informed consent

is possible, it is best that this be taken to

protect all the parties concerned.


114/129

A patient who is mentally and legally competenthas the right to refuse the touching of his body

or to submit to a medical or surgical procedure

no matter how necessary, nor how imminent the

danger to his life or health if he fails to submit to

treatment.


115/129

Sterilization is the termination of the ability toproduce offspring's. The husband and the wife

must consent to the procedure if the operation isprimarily to accomplish sterilization. If emergency

cases like ectopic pregnancy and abruptioplacentae, consent from patient is sufficient.

MEDICAL RECORDS


116/129

MEDICAL RECORDS

created as a means of communication amonghealth care practitioners.

serve two important functions: 1.to provide legal

documentation, and 2.obtain third party payments(e.g. Medicare)

good evidence in legal suits but are not

admissible evidence against the patient.


117/129

The nurse should exercise reasonable

care in selecting equipment to be usedin patients. Generally, a nurse is not

liable for a non-observable and non-

discoverable defect in the equipment.

WILL


118/129

WILLAn act whereby a person is permitted bylaw to have control in the manner of

disposing his estate but will take its

effect at the time of his death.

Important terms


119/129

Important terms

Decedent : a deceased person Testator : the dead person who made

the will (male)

Testatrix : the dead person who madethe will (female)


120/129

Two types of succession by heirs1. Testate succession : the mode of

succession wherein the heirs inherit by

virtue of a last will and testament.

2. Intestate : succeeding by law and not

governed by a will.* Without a last will and testament : heirs

should divide estate in equal sharin


121/129

Two types of last will and testamentConcerning properties & Concerning

body / life

1. Notarial/Ordinary will

2. Holographic will

Notarial or Ordinary Wills : Thefollowing are the nursing


122/129

g g

considerations :

1. Check the patients level of consciousness :

the nurse must ascertain that the patient is

capacitated to make a will

2. Check the proper locations of thesignatures :

a. at the end of the will written by the patient

b. in all pages at the sides of the paper, by thetestator/testatrix and 3 witnesses.

3. Presence of three witnesses


123/129

Holographic Will : wills that are executedduring emergencies but the patient is stillconscious.

Requisites of a holographic will :

1. It should be entirely handwritten 2. It should be dated and signed using the

hands of the testator/testatrix.

* If nobody witnessed the writing of the will,comparison to other documents made bythe testator/testatrix is necessary to ensureits validity.


124/129

Advanced directives : are directions orinstructions made by the patient in

advance with what to do with the

patients body, such : 1. Living will

2. Instructions for DNR, cremation,

organ donation, and funeral services


125/129

Legal rights of a nurse and illegaldetention :

Illegal detention is a crime if a person,such as a nurse, will limit the freedom of

a patient to move or travel from one

position / place to another

Exception : when there are quarantine

regulation orders such as what happen

in migration

HEIR is a person called to succession either by

the provision of a will or by operation of law


126/129

the provision of a will or by operation of law

There should be a witness who knows thehandwriting and signature of the testator explicitly

declares that the will and the signature are in the

handwriting of the testator

ORAL WILL is also called as NUCUPATIVE WILLor NUNCUPATION it is during the last illness, that

it is done in the place in which a he dies, that he

asked one or more witness to the will, that the willbe put in writing within a given number of days,

that it be for probate within a specified time

NURSES OBLIGATION IN THE

EXECUTION OF A WILL


127/129

EXECUTION OF A WILL

The nurse should note the soundness of the

patients mind and that there was free from

fraud or undue influence and that the patient

was above 18 years or of age . The patient should write that the will was

signed by the testator, that the witnesses

were all present at the same time andsigned the will I the presence of the testator

WHAT SHOULD A NURSE REMEMBER ABOUT

WILLS?


128/129

LLS?

A nurse especially those taking care of well-to-dopatients should remember that the main requisite

for making a will is testamentary capacity or sanity.

The person who makes a will should at least be 18

years old and is not prohibited by law. T

The will is written and should be witnessed by

three credible witnesses, unless it is holographic

will. There is no legal reason for the nurse to refuse to

witness the preparation of a will.

WHAT IS AN INCIDENT REPORT


129/129

It is an administrative report that is requiredof nurses if there are violations of standards

and policies whether or not injury occurs.

Through incident reports, hospital

administration can monitor quality of patientcare and institute some measures to prevent

similar incidents in the future.

prof ad lecture

Documents