In the last module, we looked at the standards that define nursing practice, including the ANA standards, the Nurse Practice Act, and those of other agencies. I am Professor Hoffman. In this module, we will look at the areas of legal and ethical considerations for nursing. The learning objectives for the modules are listed in the module reading guide and include explaining legal liability terms, understanding elements of legal liability, understanding the concepts of patient confidentiality, in understanding the ANA social media guidelines, and also to recognize the purpose and provisions of the ANA Code of Ethics.
The State Nurse Practice Act gives the legal boundaries of practice for nurses. Failure to practice within those boundaries can result in legal liability for the nurse resulting in disciplinary actions or revocation of their license by the Board of Nursing, which administers the Nurse Practice Act for the state. Nurses can be found legally liable when their actions are identified as negligence, malpractice, or a breach of patient confidentiality.
Negligence and malpractice differ in severity. Negligence is conduct lacking in due care, carelessness, or deviation from the standard of care that a reasonable person would use in a particular set of circumstances. Malpractice is negligence on the part of a professional acting recklessly or with intent to do harm. Cases of negligence and malpractice are handled in civil court.
A number of criteria must be met in court to find an individual guilty of either negligence or malpractice. First, there must be a recognized duty or action or responsibility on the part of the nurse owed to the patient or client. This means there must be an identified formal nurse-patient relationship. Second, there must be proof that that owed duty was not provided properly.
Third, adverse results of... not providing the duty must be foreseeable or predictable. Fourth, failure to provide the duty must be demonstrated to be the cause of subsequent injury.
The actual presence of the injury due to the nurse's failure is the fifth criteria. And finally, the injury must result in damage to the patient. Again, all five criteria must be established to prove negligence or malpractice.
The duty owed is identified in the various recognized standards we looked at in the previous module. Failure to practice within those standards will provide evidence of negligence. The text lists several examples of actions or inactions on the part of a nurse that would possibly be viewed as negligent.
The severity of the discipline or punishment will be determined by the extent of the harm and whether the negligence was intentional or not. Patient confidentiality is a patient right under federal and state guidelines. Failure to maintain patient confidentiality may result in disciplinary action and legal liability.
The federal regulations are the Health Insurance Portability and Accountability Act, or HIPAA, of 1996. As student nurses, as well as after graduation, you are required to follow the HIPAA regulations. The text gives a list of common HIPAA violations to avoid. gossiping, leaving medical records, including electronic records, unsecured, unauthorized access to medical records, sharing medical information with others not authorized to have access to that information, sharing information with family and friends without the patient's authorization, electronically sending patient information unencrypted, and sharing information on social media. Social media has become a major concern for nursing as well as the other professions.
The ANA has established principles for the use of social media by nurses. Remember these principles are professional standards of performance and violating them opens the nurse to liability and possible disciplinary or legal action. Review the tips from ANA listed in the text as well.
The first of the ANA standards of nursing performance is ethics. Ethics provide a guiding truth, a value, or an assumption for proper and acceptable action. Ethical principles in healthcare include beneficence, which is doing good, non-maleficence, which is to do no harm, autonomy, which is recognizing the right of control by the individual, and justice or fairness.
Each profession establishes its own code of ethics. The ANA Code of Ethics contains nine provisions or statements of guiding principles. You can review the provisions and the brief descriptions in the text.
In the next module, we will look at nursing process, which again contains the elements of the ANA Standards of Nursing Practice.