����������������LEGAL ISSUES THAT AFFECT THE NURSE AS A PROFESSIONAL�PRESENTED BY NJERI GAITHO�9^TH DECEMBER 2021��

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KNH NNAK BRANCH CONTINOUS PROFESSIONAL DEVELOPMENT

DEFINATION

• This is something that happens and has legal implications and may result to litigation.
• These issues affect the patient /client and also the healthcare provider.
• Legal issues are governed by the laws that are in existence.
• Breach of these laws lead to loss of practice license. Disciplinary actions, loss of employment and litigation.

The legal issues that may effect nurses in the cause of their professional duties include but not limited to:

• Documentation
• Informed consent
• Confidentiality
• Breach of professional code of ethics
• Breach of institutional policies, code of conduct and ethics
• Licensure

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DOCUMENTATION

• Material that provides official information or evidence that serves as a record.
• Documentation must be thoughtful, thorough, accurate and truthful.
• Good documentation provides evidence against miscommunication and misconception.
• It guards against lengthy litigation process.
• It is impossible to prove what you did or said unless it is clearly documented.

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• “General rule” Not documented not done.
• Not done should also not be documented as done.( non maleficence).
• Documentation need to be beyond what was literally performed.
• E.g medication administered, which antibiotic? What dosage? Which route?
• Documentation should include thoughts, statements and intentions of both the provider and care recipient.
• Overall philosophy of care is LISTEN, and note all the patients ,family or guardians concerns.

• Concerns maybe, not to feed before having their medication, ambulation after surgery, why starve before a surgical procedure.
• Document all the matters discussed with the patient, family or guardian.
• proper documentation can exonerate you from false allegations , and possible litigation.
• Proper documentation can save a patient from life threatening situations
• . Documentation must be complete with the patient / client bio data
• Identification number.

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• The author of the document, name clearly written and signed.
• The author should be clearly identifiable i.e. Names recognized in the institution.
• The documentation should be done on the prescribed forms.
• It should be legible .
• Should be in the acceptable language by law or institutional policy.

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INFORMED CONSENT

• Informed consent is the process of providing essential information to a patient, client or guardian.
• This information pertains to medical , nursing procedure or treatment.
• Involves agreement by the patient/client by signing the prescribed documents.
• A signature does not necessarily prove that the patient /client has consented.
• Includes the actual procedure benefits and risks involved.

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Legal provisions on consent

• Article 35 (1) provides for the right of access to information held by another person and required for exercise of protection of any right or fundamental freedom
• Right to highest attainable standard of healthcare under article 43 (1).

Exceptions to informed consent:

• Emergencies which ae life threatening
• Serious medical complication in the cause of the planned procedure.

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• A separate informed consent may not be necessary if the second procedure is critically incidental to the initial and it s life saving.
• Legal capacity:
• Who is legally capable of giving an informed consent?
• Adult persons of sound mind.
• Guardian/ parent/power of attorney.
• Authorized person by law or the institutional policy.

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• Absence of informed consent denies the patient/client the choice of alternative treatment or service.
• The terms used should be understandable to the patient/client.
• Patient should be given an opportunity to ask questions or clarifications.
• Parties to a consent:
• The consent must be completed by name and signature of the patient/client/next of kin or guardian.
• Person authorized by law.

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CONFIDENTIALITY

• It is one of the core duties of nursing practice.
• Requires the nurse to keep a patient ‘s personal health information private unless consent to release the information is obtained.
• A nurse should not disclose any of the patients information without prior authority.
• Information concerning patients health status, treatment ,stay in the facility and any other personal patients information on the hospital records.

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EXCEPTIONS TO CONFIDENTIALITY

• Patients consent
• Under court order or under applicable law
• When non disclosure of the information presents a serious threat to public health.

BREACH OF PROFESIONAL CODE OF ETHICS.

Principles of nursing include:

• Autonomy
• Beneficence
• Non maleficence
• Justice (fairness)
• Confidentiality

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BREACH OF INSTITUTIONAL POLICIES AND CODE OF CONDUCT AND ETHICS

• KNH code of conduct is derived from the public officers ethics Act
• Includes performance of ones duties to the best of skills and ability.
• Ensure services are provided efficiently and honestly.
• Integrity .
• Transparency and accountability.
• Stewardship .

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• Respect for people
• Decorum and dignity both in public and private.
• Harassment- no employee shall belittle ,abuse or demonstrate unwelcome behavior to colleagues, clients or other members of the public.
• Responsible use of ICT.
• Pecuniary embarrassment.

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LICENSURE

The body mandated by law to license nurses to practice is the Nursing Council of Kenya.

Established by cap 257 Laws of Kenya.

Retention of practice certificate is done annually.

Practice of the nursing duties without a valid license is an offence.

• MEDICAL MALPRACTICE
• this occurs when a healthcare professional neglects to provide appropriate treatment, omits to take appropriate action or gives sub standard treatment that causes harm ,injury or death to a patient.
• Often involves medical errors.

Elements of professional malpractice

Duty of care –owed to the patient

Breach of that duty of care

Direct cause –establishing that the breach caused the injury to the patient.

Damage –economic and non economic losses suffered as a result of the injury.

• Difference between malpractice and negligence is that in malpractice

there is an element of intent.

Example omitting to carry out a critical procedure because the patient

Has not paid.

Medical negligence does nit involve intent.

It applies when a medical practioner make a ‘mistake’ in management of a patient and the mistake results to harm.

this is by act or omission.

Both torts are actionable.

Medical negligence that may lead to litigation

• Surgical errors
• Medicine administration errors
• Blood transfusing errors
• Mis- documentation
• Mis - reporting

ALWAYS ENDEAVOUR TO DO WHAT IS RIGHT

‘THERE IA NO RIGHT WAY TO DO THE WRONG THING’

WAYLON JENNINGS

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THANK YOU