ETHICAL AND LEGAL ASPECT IN CRITICAL CARE UNIT.pptx

Ethics explains what is expected from nurses working in ICU. Ethics play significant role in health care delivery system. legal aspect explain the area of civil law is divided into many categories, two of which contracts and torts.

1. ETHICAL AND LEGAL ASPECTS IN CRITICAL CARE UNIT MS DRASHTI PATEL NURSING TUTOR

2. INTRODUCTION Ethics explains what is expected from nurses working in ICU. Ethics play significant role in health care delivery system. Nurses at every level experience different ethical issues during their work life such as:

3. 1. Patient admitted in CCU is critically ill and are at life threatening conditions. nurse should convey correct information regarding patient's heal, condition to their family members. 2. Taking informed consent creates ethical problem because patient is very sick. This covers the principal of autonomy. Informed consent ensures patient's permission to do diagnostic to therapeutic procedure.

4. 3. Nurses need to use critical thinking skill while dealing with medico-legal cases in CCU. For example , road traffic accident, suicide attempt, burn, etc. fall under medico-legal case. 4. Updated and complete nursing documentation is very important. 5. A record must be correct, clear, comprehensive, concise and chronological.

5. 6. Protecting patient's rights and human dignity is very important. 7. Use of physical and chemical restrains restricts patient's movements, thus affect patient's autonomy. So, nurses should use restrains only when all other alternative interventions are failed. 8. Use of advance life support is again ethical dilemma How long it should be used and what about patient's DNR (do not resuscitate) orders.

6. 9. At the end of life, communicate frequently with family instead of conveying bad news suddenly. 10. Provide consistent and honest information. 11. Although, staffing norm in ICU is 1:1. But due to shortage of nurses and equipments in critical care unit, sometimes patient's nursing care may be neglected.

7. ETHICS AND LEGAL ASPECTS Ethics in ICU Definition of ethics It is refers to the study of philosophical ideas of right and wrong behavior Ethical principles that nurse should must consider when providing care of patient in ICU are following principles Accountability: It refers to the ability to answer for one's own action Reasonability: It refers to the specific accountability or liability associated with the performance of duties of particular role.

8. Confidentiality: It is the principle that an institution or individual should not reveal information about their patient to a third party without the patient knowledge Autonomy : It refers to the right to make one's own decisions Nonmaleficence: It is duty to do no harm Beneficence: Means doing good

9. Justices: Is often referred to as fairness Fidelity: Means to be faithful to agreements and promises

10. LEGAL ASPECTS The area of civil law is divided into many categories, two of which contracts and torts The law of contracts contains a set of rules governing the creations and enforcement of an agreement between two or more parties

11. Intentional torts Assault Battery False imprisonment Trespass Infliction of emotional distress

12. Specific torts Defamation Slander Libel Invasion of privacy

13. Unintentional torts Negligence Medical / nursing treatment torts Professional malpractice Abandonment

14. Strict liability • Products liability

15. Intentional torts It is an purposely act on patient Assault: It is the act is a behaviour the place the plaintiff (the one being wronged who later sues) in fear or apprehension offensive physical contact Battery: It is the unlawful or offensive touching to the plaintiff False imprisonment: It is detaining, confining or restraining another against his or her will

16. Trespass: One type involves persons land and the other involves his or her personal property, handling the another person property Infliction of emotional distress: It is one of extreme misconduct or outrageous behaviour

17. Specific torts Defamation: It is composed of two torts - slander, (oral defamation) and libel (written defamation). Defamation is not mere statement or writing of words that injuries one's reputation or good name; the words must be communicated to another Invasion of privacy: It involves the violation of person rights to privacy nurses can invade another's privacy by revealing confidential information without authorization or by failing to follow the patient health decision

18. Unintentional torts Negligence: It is failure to meet an ordinary standard of care, resulting in injury to the patient or plaintiff. Malpractice : It is type of professional liability based on negligence and includes professional misconduct, breach of a duty or standard of care, illegal or immoral conduct, or failure to exercise reasonable skills, all of which lead to harm

19. Abandonment: It is a type of negligence in which duty to give care exists, is ignored, and results in harm to a patient. It is the absence of care and the failure to respond to a patient that may give rise to an allegation of abandonment