MEDICOLEGAL NEW presentation in detail....

detail

1. Quotations are commonly printed as a means of inspiration and to invoke philosophical thoughts from the reader.

2. PRESENTATION ON MEDICOLEGAL CASE

3. The student will able to : 1. Define medicolegal issues . 2. Explain the legal issues specific to nursing . 3. Describe the legal issues in speciality & practice area . 4. Enumerate the legal, ethical , professional issues in nursing . 5. List out the do ,s & don ,t s as guidelines for safe practice . 6. Responsibility of nurse manager in legal issues . OBJECTIVES

4. INTRODUCTION

5. DEFINITION A medico-legal case can be defined as a case of injury in which investigations by the law-enforcing agencies are essential to fix the responsibility regarding the causation of the injury .

6. 1. MLC-Medico legal cases :- Malpractice-a deviation of professional duty or a failure to exercise an ordinary degree of professional skill or learning by one (such as a physician) rendering professional services which results in injury, loss, or damage . TERMINOLOGY

7. 2. Assault and battery- The action of threatening a person together with the action of making physical contact with them 3. Consent- Consent is your agreement for a doctor or healthcare professional to provide you with treatment , including any medical or surgical management , care , therapy , test or procedure . 4. Abortion- Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus. 5. IVF - In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro ("in glass") 6. Surrogacy- The process of giving birth as a surrogate mother or of arranging such a birth.

8. A. LEGAL ISSUES SPECIFIC TO NURSING 1. Duty to seek Medical Care for the patient :- It is the legal duty of the nurse to ensure that every patient receives safe and competent care. The nurse cannot guarantee the patient will receive medical care that the nurse be a strong advocate for the patient and use every resource to ensure medical care is received. 2. Confidentiality It is a privilege to care for other people. At times, your patients will relate to you in a personal way. One of the outcomes of your relationship is that you may be told information of a personal nature in addition to what a patient may share with you, you have access to the person‘s hospital records.

9. 3. Permission to provide treatment When people are admitted to hospitals, nursing homes and home health services, they sign a document that gives the personnel in the organization permission to treat them. Every time the nurse provides nursing care to person, however, permission must be obtained. 4 . Informed consent The concept of permission to treat is closely tied to the concept of informed consent. The law states the persons receiving health care must give permission to treat based on informed consent. The principle of informed consent states that the person receiving the treatment fully understands the possible outcomes, alternatives to treatment and all possible consequences.

10. 5. Advance Directives Although the Patient Self – Determination Act was passed by the U.S. Congress in 1990, it was not implemented until 1992. The act states that all the health care institutions are required to give clients or patients an opportunity to determine what lifesaving measures or life-prolonging actions they want implemented. 6. Negligence The law requires nurses to provide safe and competent care. The measure of safe and competent care is the standards of care. A standard of care is the level of care that would be given by a comparable nurse in a similar situation.

11. Requirements to establish negligence : There are four legal requirements that must be met , for negligence to be proved:- A standard of care exists . A breach of duty. Damages or injury has resulted from the breach of duty. The injury or damage m ay happen from the nurse‘s negligence.

12. 7 . Malpractice Malpractice is a term used for negligence. Malpractice specifically refers to negligence by a professional person with a license. You can be sued for malpractice once you have your LPN license. If you are a nursing assistant right now, you may be negligent, but it wouldn‘t be malpractice because you are not licensed. 8. Fraud Few cases of fraud exist in nursing, but it does need to be mentioned. Fraud is a deliberate deception for the purpose of personal gain and usually is followed as a crime. Most courts are harder on cases of fraud compared with cases of negligence or malpractice because fraud is deliberate and results in personal gain.

13. 9 . Assault and Battery Assault is the threat of unlawful touching of another, the willful attempt to harm someone. Battery is the unlawful touching of another without consent, justification, or exercise. In legal medicine battery occurs if a medical or surgical procedure is performed without patient consent. 10 . False Imprisonment Preventing movement or making a person stay in a place without obtaining consent is false imprisonment. This can be done through physical or non physical means.

14. 11. Invasion of privacy Clients have claims for invasion of privacy‘, e.g. their private affairs, with which the public has no concern, have been publicized. Clients are entitled to confidential health care. All aspects of care should be free from unwanted publicity . 12 . Nurse Practice Act Each state has what is called a Nurse Practice Act. The guidelines and laws outlined in the act pertain to all nurses who are licensed in that particular state. Nurse limitation is one of those laws. Each nurse has a limitation on what he is allowed and trained to do.

15. 13 . Patient's Advocate

16. 14 . Administering Medication

17. 15 . Report It or Tort It Allegations of abuse are serious matters. It is the duty of the nurse to report to the proper authority when any allegations are made in regards to abuse towards a vulnerable population . If no report is made, the nurse is liable for negligence or wrongdoing towards the victimized patient.

18. 16 . Rights to Privacy

19. 17 . Document

20. B. LEGAL ISSUES IN SPECIALITY AND PRACTICE AREA

21. MATERNAL AND INFANT NURSING

22. A likely against a doctor who is in charge of looking after mother and infant might be one of the following:- 1. Failure to diagnose a high risk pregnancy. 2. Delay in performing a caesarean section. 3. Improper vaginal delivery 4. Improper use of forceps.

23. 5. Incidence surrounding including labor and the use of oxytocin . 6. Delay in arriving at the hospital.

24. common causes for lawsuits against nurses

25. MEDICAL SURGICAL NURSING

26. OVER LOOKED INSTRUMENTS CRITICAL CARE UNITS MAINTENANCE OF RECORDS & REPORTS INJURY DUE TO WRONG MEDICATION /DOSE/ CONCENTRATION BURNS FALL INJURY DUE TO DEFECTIVE APPARATUS FALL TO REPORT ACCIDENT S

27. INFORMAL ADMISSION RESTRAINTS DISCHARGE PSYCHIATRIC NURSING

28. COMMUNITY HEALTH NURSING

29. COMMUNITY HEALTH NURSING INTENTIONAL TORTS UNINTENTIONAL TORTS

30. INTENTIONAL TORTS

31. NEGLIGENCE LIABILITY MALPRACTICE UNINTENTIONAL TORTS

32. NURSING & MIDWIFERY COUNCIL RESPECTING CONFIDENTIALITY RESPECTING AUTONOMY C. Legal, Ethical, Professional Issues in Nursing

33. GUIDELINES FOR SAFE PRACTICE

34. Do’s 1. Documentation of all unusual incidences. 2. Report all unusual incidences. Know your job description. 3. Follow policies and procedures as established by your employing agency. 4. Keep your registration updated. Don’ts 1. Give medical advice to friends and neighbours . 2. Attempt to practice medicine. 3. Witness a patient‘s will. 4. Take medications that belong to patients. 5. Worked as a licensed practical/ vocational nurse in a state in which you are not licensed.

35. Roles and Functions of Nurse Manager in Legal Issues a. Serve as a role model by providing nursing care that meets or exceeds accepted standards of care. b. Seeks professional certification to increase expertise in a specific field. c. Reports substandard nursing care appropriate authorities.

36. d. Maintain nurse/ patients relationships that are respectful, caring and honest, thus reducing the possibility of future lawsuits. e. Practices nursing within the area of the individual competence. f. Prioritizes patient‘s rights and welfare first in decision- making. g. Demonstrates vision, risk taking and energy in determining appropriate legal boundaries for nursing practices thus defining what nursing is and should be in the future.

37. h. Delegates to subordinates wisely, looking at the managers scope of practice and that of those they supervise. i. Understands and adheres to institutional policies and procedures. j. Practices nursing with scope of state nursing within the scope of the state nurse practice act. k. Monitors subordinates to ensure that they have a valid, current and appropriate license to practice nursing.

38. ABSTRACT 1. Medico Legal Issues in Obstetrics and Gynecology Savana Pradhan , Obstetrician and Gynecologist. Gynaecologists, like other healthcare professionals, have a legal obligation to adhere to a reasonable standard of care while acting in their professional capacity (the ‘duty of care’) . A breach of this duty, whether due to an individual’s actions such as poor decision-making or corporate causes such as destitute safety culture in the organisation, could lead to litigation. This review discusses the burden and causes of litigation in gynaecology and outlines the process taken by a medico-legal claim. Failure to diagnose, intra-operative complications, unnecessary surgery, consent issues, poor supervision and retention of foreign bodies are common causes.

39. The improved knowledge of healthcare professionals on the up- to-date Clinical Guidelines along with the law of Land concerning medico Legal issues will be constructive in health service delivery by reducing the amount of litigation in Obstetrics and Gynecology. Appropriate use of informed consent, counseling, documentation and proper record keeping is a top priority. Telephone consultation and Telemedicine may attract various liability issues. Hospital administration policy of risk management including regular audits, near-miss investigation, mortality-morbidity discussions, and timely reviews of Clinical guidelines will help reduce litigation in these fields.

40. 2. Medico – Legal Issues in Clinical Practice Bello Tukur Esq, LLB(HONS) BUK, BL (LAGOS)1; DR. C.A. Nkanta MBBS, FWCS, FICS, FAO . The clinicians work is very likely to involve Law if anything goes wrong in the course of treatment, prescription or surgery. The problem of professional practice are of course, the ones which give rise to the most obvious and immediate concern, but apart from these issues medical staff face the same wide range of legally enforceable rights and duties as other employees in their everyday work.

41. These medico-legal cases center mainly on the issue of consent, duty of care and rules of professional ethics. If the clinicians properly obtained consent before embarking on extensive medical procedure or treatment and also exercise care to the patient as well as observance of the rule of professional ethics, by so doing the clinician can easily exonerate himself from any charge or allegation arising from medico-legal cases .

42. NURSES PRIORITY SELF SAFETY EMERGENCY PATIENT CARE

43. Reference BOOKS 1. Vati jogindra , principles and practice of nursing management and administration , Jaypee brothers medical publishers , 2nd edition , page no - 54 . 2. K. Deepak , C. Sarath Chandran , B.P. Mithun kumar , A comprehensive Text book on nursing management , EMMESS Medical Publishers , Page no - 524-536 . JOURNALS 1. Bernstam VA. CRC Handbook of Gene Level Diagnostics in Clinical Practice. CRC Press; Aug 11 . 2. Thomas J. Medical records and issues in negligence. Indian journal of urology: IJU: journal of the Urological Society of India. 2009 Jul;25(3):384.

44. 3. Raveesh BN, Nayak RB, Kumbar SF. Preventing medico-legal issues in clinical practice. Annals of Indian Academy of Neurology. 2016 Oct;19(Suppl 1):S15. 4. Sinai Talaulikar V, Arulkumaran S. Medico-legal issues with CTG interpretation. Current Women's Health Reviews. 2013 Aug 1;9(3):145-57. 5. Edozien LC. Medico-legal issues in gynaecology. Obstetrics, Gynaecology & Reproductive Medicine. 2012 Oct 1;22(10):273-8.

45. WEBSITE 1. Mr Rubin Migron , Medico Legal & ethical issues in nursing- issues in india , Published on Apr 24, 2017 at :https://www.slideshare.net/MigronRubin/legal-ethical-issues-in-nursing-issues-in-india . 2. Dr sharma chetan , Medico-legal issues in casualty and Hosptial , Published on Nov 1, 2015 , Published in: Health & Medicine at : https://www.slideshare.net/drchetansamra/medico-legal-issues . 3. Dr Das N.C , Medico legal case, Published on Feb 27, 2012 , Published in: Health & Medicine, Business at : https://www.slideshare.net/NcDas/medico-legal-case .

46. THANKS! Any questions? You can find me at @username & [email protected]