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Legal Issues in Health Care

Legal issues

Dede carr, BS, LDAKaren Neu, MSN, CNE, CNP

Split? Yes, Take out slide #4, Label it Competency #5 (see picture to the right). Competency 4 PP 1-40. Put Competency 5 before Slide 41 Intentional Tort. Competency 5: 41-end.

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Competencies: Discuss how confidentiality must be

maintained in healthcare facilities with clients and their medical records. Define confidentiality. Discuss examples of confidential information Discuss with whom confidential information

can be shared Define libel and slander.

Legal Issues

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Invasion of Privacy: a direct wrong of a personal nature that injures the feelings of the person and does not take into account the effect of revealed information on the standing of the person in the community.

Privacy is the right of individuals to withhold themselves and their lives from public scrutiny, or the right to be left alone.

Liability can result if the healthcare worker breaches confidentiality by passing along confidential client information to others or by intruding into the client’s private domain. (Ramont & Niedringhaus, p. 30)

Intentional Tort

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Patients have a right to their person and personal affairs kept confidential.

Protect the patient from exposure of his/her body. Knock & pause before entering the patient’s room. Draw the curtains when providing cares. Leave the room while visitors are with the patient. Do not listen to patients as they make calls. Abide by the rules of confidentiality. Do not try to force a patient to accept your personal

beliefs or views. Do not discuss the patient’s condition with anyone

outside of work. (Hegner, Acello, Caldwell, p. 42)

Invasion of Privacy

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Necessary discussion about a client’s medical condition is usually considered appropriate, but unnecessary discussion and gossip are considered a breach of confidentiality.

Necessary discussion involves only those people engaged in the client’s care.

Four major areas of confidential client information must be reported:1. Vital statistics (births, deaths)2. Infections and communicable diseases (syphilis)3. Child or elder abuse; any abuse4. Violent incidents (knife or gunshot wounds)

(Ramont & Niedringhaus, p. 30)

Invasion of Privacy-Tort

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As of April 14, 2003, healthcare agencies and providers must adhere to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). (Ramont & Niedringhaus, p. 30)

Patient Information--The ethical code asserts that information about clients is privileged and must not be shared with others. (Hegner, Acello, & Caldwell, p. 37)

Invasion of Privacy-Tort

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Discuss client information only in appropriate places: It is unwise to discuss a patient’s condition while in a

patient’s room, even if the patient is unconscious. The patient may be able to hear & it could cause unnecessary worry.

Never discuss the patients in your care with your family or in the community.

Never discuss the patients during lunch or breaks, even with your coworkers. (Hegner, Acello, & Caldwell, p. 37)

Confidentiality

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Discuss patient information only with the proper people.

At times you may be approach by others requesting information about a patient.

For example, you might be asked for such information by other patients, family members, or members of the public, such as news reporters.

Discuss patients and their personal concerns only with your supervisor during a conference or report.

Make sure you are not being overheard by visitors or other patients.

You will learn to evade inquires tactfully: Stating that you do not know all the details of the treatment or the patient’s condition.

Redirecting inquires to the proper authority. Firmly, but politely, indicate that you do not have the authority

to provide the answers they seek. (Hegner, Acello, & Caldwell, p. 37)

Confidentiality

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Refer patient’s questions about laboratory results, the patient’s condition, or course of illness to the nurse or doctor.

Let the nurse/doctor relay information about a client’s death. Never give information concerning a client’s death to the patient’s family. When done with tact, a refusal if this kind is rarely resented by the family.

(Hegner, Acello, & Caldwell, p. 37)

Confidentiality

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Defamation: Communication that is false, or made with a careless disregard for the truth, and that results in injury to the reputation of a person.

Libel: Defamation by means of print, writing, or pictures. Writing in a patient’s chart that the physician is incompetent

because he doesn’t respond immediately to a call is an example of libel.

Slander: Defamation by the spoken word, stating information or false words that can cause damage to a person’s reputation. An example of slander would be for the healthcare worker to

tell the client that another healthcare worker is incompetent.

(Ramont & Niedringhaus, p. 30)

False Communication-Tort

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If a comment that criticizes a person’s competence is made to that person in private, it is not defamation because a third party cannot hear it.

It is slander only if it is communicated to a third party.

Nurses are allowed to make statements that could be considered defamatory, but only as part of nursing practice and only to a physician or another healthcare team caring directly for the client, for example: “The client exhibits inappropriate sexual behavior.” (Ramont & Niedringhaus, p. 30)

Defamation-Slander

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Client property, such as jewelry, money, eye glasses, and dentures is a constant concern to hospital personnel.

Many agencies request that client’s leave valuables at home to decrease the risks of lost property.

Sometimes situations arise in which the client may have valuables & facilities have policies to safeguard the client’s property.

Healthcare workers are expected to take reasonable precautions to safeguard a client’s property, and they can be held liable for its loss or damage if they do not exercise reasonable care. (Ramont & Niedringhaus, pp. 30-31)

Loss of Client Property

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Taking anything that does not belong to you makes you guilty of theft. If you are caught, you are liable. The article taken need not be large or expensive to be considered stolen.

Even if patients offer an item to you, do not take it. Some patients may not be aware of their offer later, and it could look

bad. If you see someone stealing something and you do not report it, you are

guilty of aiding and abetting the crime. Because of the nature of work in healthcare, people must be honest and

dependable. Despite careful screening, dishonest people are sometimes hired and

things begin to disappear. These range from washcloths, money, patient’s personal belongings to

drugs. Sometimes workers are reluctant to report things that they see other

people doing. Remember you are responsible for your own actions & must take the

proper actions. (Hegner, Acello, & Caldwell, p. 39)

Theft

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A crime is an act committed in violence of public (criminal) law and punishable by a fine or imprisonment.

Crimes are classified as either felonies or misdemeanors.Crimes are punished through the criminal action by the state

against an individual. A felony is a crime of serious nature, (i.e., murder) punishable

by prison. In other areas, second-degree murder is called manslaughter. A misdemeanor is a less serious offense than a felony and it is

usually punishable by a fine, a short-term jail sentence, or both. A healthcare worker who slaps a client’s face could be charged

with a misdemeanor. (Ramont & Niedringhaus, p. 31)

Criminal Law

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Stay within your scope of practice & do not overstep your authority

Do only things that you have been taught to do and that are within your scope of training.

Carry out procedures carefully as you were taught. Request guidance from the proper person before you

take action in a questionable situation. Always keep safety and the well-being of the client

foremost in your mind and act accordingly. (Hegner, Acello, & Caldwell, p. 41)

Interventions to Prevent Law Suits

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Make sure you thoroughly understand directions for the care you are to give; don’t be afraid to ask questions to clarify.

Perform your job according to the facility’s policies. Maintain in-service/educational requirements of

OBRA Stay within the OBRA guidelines. Do no harm to the patient. Respect the patient’s belongings (property).

(Hegner, Acello, & Caldwell, p. 41)

Interventions to Prevent Law Suits

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Burke, A. (2010). Legal aspects and ethics. Retrieved from

http://www.nursingassistanteducation.com/site/courses/eng/nae-liae-eng.php

Hegner, B.R., Acello, B., & Caldwell, E. (2004). Nursing assistant: A nursing process approach (9 th

ed.). Clifton Park, NY: Thompson Delmar Publishing

Minnesota Department of Health. (2001, December). Safety without restraints: A new practice standard

for safe care. Retrieved from http://www.health.state.mn.us/divs/fpc/safety.htm

Parker-Feliciano, K. (2006). Legal and ethical aspects of nursing. In B.L. Christensen & E. O. Kockrow

(Eds.). Foundations and adult health nursing (5th ed.) (pp. 270-314). St. Louis, MO: Elsevier, Mosby

Ramon, P.R. & Niedringhaus, D. M. (2008). Infection control and asepsis. Fundamental nursing care

(2nd ed.) (pp. 149-176). Upper Saddle River, NJ: Person Prentice Hall

References