Professional Documents
Culture Documents
Maternal/Newborn and
Womens Health
Developed by
D. Ann Currie , R.N. , M.S.N.
LEGAL CONSIDERATIONS
GENERAL LEGAL CONCEPTS
ARENAS FOR CONSIDERATION
LITIGATION
RISK MANAGEMENT
QUALITY ASSURANCE
DOCUMENTATION
CLINCAL EXAMPLES OF COMMON LEGAL
ISSUES
GENERAL LEGAL CONCEPTS
LAW CAN BE DEFINED ASTHOSE RULES
MADE BY HUMANS WHICH REGULATE
SOCIAL CONDUCT IN A FORMALLY
PRESCRIBED AND LEGALLY BINDING
MANNER.(BERNZWEIG)
FUNCTIONS OF THE LAW IN
NURSING
THE LAW SERVES A NUMBER OF
FUNCTIONS IN NURSING:
IT PROVIDES A FRAMEWORK FOR
ESTABLISHING WHICH NURSING
ACTIONS IN THE CARE OF THE CLIENTS
ARE LEGAL
IT DIFFERENTIATES THE
NURSESRESPONSIBILITIES FROM THOSE
OF OTHER HEALTH PROFESSIONAL
CONT. FUNCTIONS
IT HELPS ESTABLISH THE BOUNDARIES
OF INDEPENDENT NURSING ACTION.
IT ASSISTS IN MAINTAINING A
STANDARD OF NURSING PRACTICE BY
MAKING NURSES ACCOUNTABLE UNDER
THE LAW.
SOURCES OF LAW
CONSTITUTION
LEGISLATION (STATUTES)
COMMON LAW
TYPES OF LAWS
PUBLIC LAW- CRIMINAL LAW
PRIVATE LAW-CIVIL LAW
CONTRACT LAW
TORT LAW
ARENAS OF LEGAL
CONSIDERATION
PERSONAL PROFESSIONAL PRACTICE
CLIENT CARE AND ADVOCACY
LEGAL CONSIDERATIONS IN
PERSONAL PROFESSIONAL
PRACTICE
SCOPE OF PRACTICE
STANDARDS OF CARE
LICENSURE
COLLECTIVE BARGAINING
SCOPE OF PRACTICE
THE NURSE PRACTICE ACT----
BROAD DEFINITION OF PERMISSIBLE
BOUNDARIES OF PRACTICE WITHIN A
STATE.
DISTINGUISHES NURSING PRACTICE
FROM THE PRACTICE OF OTHER HEALTH
PROFESSIONALS
SCOPE OF PRACTICE
EXCLUDES UNTRAINED OR UNLICENSED
INDIVIDUALS FROM PRACTICING
NURSING.
RULES AND REGULATIONS
PROMULGATED BY STATE BOARDS OF
NURSING PROVIDE OFFICIAL
INTERPRETATION OF NURSING ACTS.
SCOPE OF PRACTICE
CORRECT INTERPRETATION AND
UNDERSTANDING OF STATE PRACTICE
ACTS ENABLES THE NURSE: TO PROVIDE
SAFE CARE WITHIN THE LIMITS OF
NURSING PRACTICE AND TO AVOID THE
RISK OF BEING ACCUSED OF PRACTICING
MEDICINE WITHOUT A LICENSE
READ AND KNOW THE NURSE PRACTICE
ACT ****.
STANDARDS OF CARE
DEFINITION:
MINIMUM CRITERIA FOR
COMPETENT,PROFICIENT DELIVERY OF
NURSING CARE.
USED TO EVALUATE THE QUALITY OF
CARE PROVIDED
FORMULATED FROM SKILLS AND
KNOWLEDGE COMMONLY POSSESSED BY
MEMBERS OF
CONT.
A PROFESSION.NURSES.
IDENTIFY
HEALTH,DEMOGRAPHIC,ENIRONMENTAL,
AND PSYCHOSOCIAL PARAMETERS OF
CARE
REFLECTS CURRENT KNOWLEDGE IN THE
FIELD,AND,THEREFORE,ARE DYNAMIC
AND SUBJECT TO CHANGE.
USES OF STANDARDS OF
CARE
CRITERION FOR DETERMINING IF A
NURSE HAS VIOLATED THE STATE -
NURSE PRACTICE ACT.
CRITERION FOR DETERMINING IF A
NURSE HAS VIOLATED STATE OR CITY
CRIMINAL CODES
CRITERION ELEVATING NURSING
PRACTICE TO A PROFESSIONAL LEVEL.
INTERNAL STANDARDS OF
CARE
INDIVDUAL
INSTITUTIONAL
SET BY ROLE AND EDUCATION OF THE
NURSE: JOB
DESCRIPTION,EDUCATION,AND
EXPERTISE
SET BY INDIVIDUAL INSTITUTIONS:
POLICIES AND PROCEDURES.
EXTERNAL OR NATIONAL
STANDARDS OF CARE
EXTERNAL BECAUSE THEY SUPERCEDE
INDIVIDUAL PRACTITIONERS AND
INSTITUTIONS.
BROADER THAN LOCALITY RULES:
STANDARDS OF CARE VEIWED FROM THE
PERSPECTIVE OF CARE WITHIN A
GEOGRAPHIC AREA.
CONT. EXTERNAL
STANDARDS OF CARE
BASED ON REASONABLENESS AND
AVERAGE DEGREE OF SKILL,CARE, AND
DILIGENCE PRACTICED BY MEMBERS OF
THE PROFESSION ACROSS THE NATION.
NURSES IN A VARIETY OF SETTINGS AND
LOCALS MUST MEET THE SAME
STANDARDS: HOMES,BIRTHING
CENTERS,HOSPITALS ETC.
CONT. ETERNAL
STANDARDS OF CARE
STANDARDS ESTABLISHED BY:
STATE BOARDS OF NURSING THROUGH
NURSE PRACTCE ACTS OR
PROMULGATED RULES AND
REGULATIONS.
PROFESSIOAL ORGANIZATIONS:
ANA,ICN,OR CONGRESS FOR NURSING
PRACTICE.
CONT. EXTERNAL
STANDARDS OF CARE
SPECIALITY NURSING
ORGANIZATIONS:AWHONN,NANN, ACNM.
FEDERAL ORGANIZATIONS AND
GUIDELINE: JCAHO AND MEDICARE
RULES.
STANDARD OF CARE
NEGLIGENCE AND
MALPRACTICE
NEGLIGENCE- IT IS OMITTING AN ACT
OR DEVIATION FROM THE STANDARD OF
CARE THAT A REASONABLY PRUDENT
PERSON WOULD NOT OMIT OR COMMIT
UNDER SIMILAR CIRCUMSTANCES.
MALPRACTICE- IT IS A NEGLIGENT
ACTION OF A PROFESSIONAL
ELEMENTS OF NEGLIGENCE
THERE WAS A DUTY TO PROVIDE CARE.
THE DUTY WAS BREACHED.
INJURY OCCURRED.
THE BREACH OF DUTY CAUSED INJURY
EXAMPLES OF NEGLIGENCE
EXAMPLES OF OMISSION: FAILING TO
GIVE A MEDICATION, FAILING TO
ASSESS PROPERLY,FAILING TO NOTIFY A
PHYSICIAN OF A CHANGE IN A CLIENTS
CONDITION OR STAUS.
EXAMPLES OF COMMISSION:GIVING
WRONG MEDICATION OR TO WRONG
CLIENT
CONT.
PLACING INFANT IN WRONG CRIB OR
GIVING INFANT TO WRONG MOTHER.
CONT.
NURSES NOT MEETING APPROPRIATE
STANDARDS OF CARE COULD BE
SUBJECT TO ALEGATIONS OF
NEGLIGENCE OR MALPRACTICE.
NURSES RESPONSILITY IN
PREVENTING NEGLIGENCE
AND MALPRACTICE
OBTAIN AND MAINTAIN CURRENT
INFORMATION REGARDING THE STATE
NURSE PRACTICE ACT- GET A COPY AND
READ IT AND KNOW IT..READ
PUBLICATION FROM THE STATE (BON),
VISIT WEB SITE FOR BNE INFORMATION
AND ATTEND BNE WORKSHOPS.
CONT. NURSE
RESPONSIBLITY
OBTAIN AND MAINTAIN CURRENT
INFORMATION ON INTERNAL AND
EXTERNAL STANDARDS OF PRACTICE,
SEEK CONTINUING EDUCATION TO
REMAIN CURRENT IN SPECALITY AREAS
USE THE NURSING PROCESS WHEN
GIVING CLIENT CARE.
CONT. NURSES
RESPONSIBILITY
DEVELOPE A POSITIVE, EMPOWERING
RELATIONSHIP WITH CLIENTS---SEE
CLIENTS AS AN IMPORTANT MEMBER OF
THE HEALTH TEAM.
BE THROUGH IN COMPLETING AND
REPORTING ASSESSMENTS AND
IMPLEMENTING CARE.
CONT NURSES
RESPONSIBLITY
MAINTAIN CLEAR, CONCISE, ACCURATE,
COMPLETE, AND LEDGIBLE
DOCUMENTATION.
QUESTION APPROPRIATENESS OF CARE
WHEN HARM CAN BE DONE TO CLIENT.
CHECK MEDICAL ORDERS FREQUENTLY.
USE CHAIN OF COMMAND.
LEGAL CONSIDERATIONS
FOR CLIENT CARE
HEALTHCARE REFORM
MANAGED CARE
SHORTENED HOSPITAL STAYS
UNLICENSED ASSISTIVE
PERSONNNEL(UAP)
NURSES ROLE AS CLIENT ADVOCATE.
Healthcare reform
The USA leads the world in healthcare
spending, yet has one of the highest
infant mortality rates among the
industrialized nations..
One of the primary factors related to
infant mortality(deaths under one year of
age per 1000 live births) is an increase in
the delivery of low birth weight infants,
which is linked to lack of prenatal care.
Healthcare Reform
Barriers to access to prenatal care
1) Costs of health care
2) Limited financial resources
3)Uncoordinated service systems
4) Individual behaviors and beliefs
concerning health care
5)Bureaucratic obstacles, such as
complicated, lengthy forms for
Medicaid
HEALTHCARE REFORM
Barriers to prenatal care
6) Unavailability of maternal services in
certain parts of the country
7) Underfunded and overcrowded publicly
supervised clinics
8) Difficulty in recruiting and retaining
healthcare providers in publicly subsidized
clinics
Healthcare reform
Barriers to prenatal care
9) Lack of coordinated services for needy
individuals
10) Inaccessibility to prenatal services
because of transportation, location, and
lack of child care facilities.
11) Other.
HEALTHCARE REFORM
Federal and state governments, through
policies and legislation, have begun to
implement strategies to resolve these
barriers by:
1) Broadening health insurance coverage
for childbearing women and infants
2) Improving coordination and funding of
public programs
Healthcare Reforms