Legal Responsibilities In Health Care

LegalResponsibilitiesin Health CareShelley Westwood, RN, BSNBullitt Central HS

Introduction Every aspect of our life isgoverned by certain lawsor legal responsibilities. Ex: traffic laws It is important for thehealth care worker to beaware of and follow legalregulations Protects worker,employer and safety andwell-being of the patient12/4/2015Legal Responsibilities in Health Care2

Objectives Define and differentiate between civil lawand criminal law Define and cite examples of torts whichoccur in health care including: Malpractice Negligence Assault & Battery Invasion of privacy12/4/2015Legal Responsibilities in Health Care3

Objectives (continued) 12/4/2015False imprisonmentAbuseDefamation of characterExplain contract in the health care settingDiscuss confidentiality in relationship toHIPAA guidelinesLegal Responsibilities in Health Care4

Legal Responsibilities Authorized or based on law Two types– Civil law– Criminal law Health care professionalsare required to know andfollow state laws regulatingtheir license or registration12/4/2015Legal Responsibilities in Health Care5

Civil Law Deals with legal relationships betweenpeople and protection of a person’s rights Health care mainly affected by civil law Contracts--a written or spoken agreement,especially one concerning employment, sales, ortenancy, that is intended to be enforceable by law. Torts – wrongful act that does not involve acontract12/4/2015Legal Responsibilities in Health Care6

Criminal Law Dealing with wrongs against aperson, property or society––––12/4/2015Practicing without required licenseMisuse of narcoticsTheftMurderLegal Responsibilities in Health Care7

Legalities in Healthcare Many of the wrong doings in health careare civil wrongs instead of crimes They can lead to legal action however12/4/2015Legal Responsibilities in Health Care8

Malpractice Providing improper or unprofessional treatment or care Liability insurance is available to health careprofessionals to protect them in such events The cost, particularly for physicians has become afinancial burden for the professional Some states have higher malpractice rates than others,prompting physicians to move to other states with lowerrates12/4/2015Legal Responsibilities in Health Care9

Negligence Failure to provide care that is normally expectedof a person equally trained in that particularsituation, resulting in injury to the patient EX:– Ordered side rails left down and patient falls from bed– Using or not reporting defective equipment thatinjures patient– Patient develops infection from poor sterile techniqueby the nurse– Patient burned from bath water that was too hot Negligence by a healthcare provider ismalpractice12/4/2015Legal Responsibilities in Health Care10

Assault & Battery Assault – threatening to injure Battery – unlawful touch ofanother without their consent– Patients must give consent– To avoid charges of battery,make sure consent is obtainedfor all procedures– They have the right to refusecare12/4/2015Legal Responsibilities in Health Care11

Informed Consent Permission granted by a person of soundmind of legal age after the procedure andall risks have been explained in term thepatient understands Procedures requiring written consent:– Surgery– Invasive diagnostic tests– Treatment of minors– Siderail releases (if doctor order)12/4/2015Legal Responsibilities in Health Care12

Verbal Consent Permission is grantedafter procedure has beenexplained to patient– Ex: giving an injection,taking a blood pressure,drawing blood for a labtest, starting an IV,performing physical exam Patient may withdrawconsent at any time Never perform aprocedure on a patientwithout consent12/4/2015Legal Responsibilities in Health Care13

Invasion of Privacy Unnecessary exposure of an individual orrevealing personal information about anindividual without consent– Ex: Exposing a patient while transporting themto x-ray– Sending information to aninsurance company withoutpatient’s written permission– Informing press of patient’scondition without permission12/4/2015Legal Responsibilities in Health Care14

False Imprisonment Restraining a patient or restricting theirfreedom– Ex: side rails without a doctor’s order and apatient’s permission– Placing resident in restraints without order orpermission– Keeping patient hospitalized against their will12/4/2015Legal Responsibilities in Health Care15

Abuse Any care that results in physical harm,pain, or mental anguish Types: Physical – hitting, forcing persons againsttheir will, restraining movements,depriving food or water Verbal – speaking harshly, swearing orshouting, writing threats or abusivestatements12/4/2015Legal Responsibilities in Health Care16

Abuse - continued Psychological – threatening harm,denying rights, belittling, intimidating Sexual – any unwanted sexual touchingor act, sexual gestures or suggestedsexual behavior12/4/2015Legal Responsibilities in Health Care17

Abuse Outside of Facility Domestic – intimate partner uses threatening,manipulative, aggressive, or violent behavior Child – abuse of a child Elder – abuse directed toward an older person(may be financial in nature) Health care workers are required by law toreport any type of abuse to immediatesupervisor Laws in all states require the reporting of anyform of abuse to proper authorities12/4/2015Legal Responsibilities in Health Care18

Defamation False statements which may damage aperson’s reputation Two types:– Slander – information is spoken Ex: stating a person has a drug problem whenanother medical problem exists– Libel – information is written Ex: sending inaccurate lab results to agovernment agency12/4/2015Legal Responsibilities in Health Care19

Contracts Agreement between two or more parties Three parts– Offer – competent individual enters into arelationship with health care provider andoffers to be a patient– Acceptance – health care provider givesthem an appointment or examines and treatsthe patient– Consideration – payment made by thepatient for the physician’s services12/4/2015Legal Responsibilities in Health Care20

Types of Contracts Implied – Obligations are understoodwithout verbally expressed terms– Ex: nurse offers patient medication andpatient takes medication Expressed – stated in distinct and clearlanguage, either orally or in writing– Ex: surgery permit All risks of the procedure or treatmentmust be explained in terms patientunderstands12/4/2015Legal Responsibilities in Health Care21

Legal Disability Person does not have legal capacity toform a contract– Ex: Minors – under legal age– Mentally incompetent person– Under influence of drugs that alter mentalstatus– Semiconscious or unconscious people12/4/2015Legal Responsibilities in Health Care22

Breach of Contract Contract requires certain standards ofcare by competent, qualified individuals If contract not performed according toagreement, contract is breached Example:– Not paying for services rendered– Giving improper care12/4/2015Legal Responsibilities in Health Care23

Policies & Procedures Health care workers must be familiar withtheir employer’s policies and procedures Policies are the guidelines that provideinformation about facility rules andregulations The policies may include:– Holiday and vacation policy12/4/2015Legal Responsibilities in Health Care24

Policy & Procedures (cont) Insurance and sick leave benefits All other information concerning theoperation of that facility Procedures tell you how to complete tasksthe way your employer want them done. There may be procedures for the following:––––12/4/2015How to take a temperatureHow to give an enemaHow to fill out formsHow to package and wrap traysLegal Responsibilities in Health Care25

Policies & Procedures (cont) These guidelines assure that the healthcare worker performs their jobs correctly Always follow your facility’s policies andprocedures In this manner your are protectingpatients, co-workers, your employer, andyourself12/4/2015Legal Responsibilities in Health Care26

Confidential Information All information given to health personnel by apatient is considered privileged communication,and by law must be kept confidential Health care records are also consideredprivileged communication Discuss patient information only with immediatesupervisor Health care workers can be fined, sued, or losetheir job for sharing nay information aboutpatients with others12/4/2015Legal Responsibilities in Health Care27

Confidential Information (cont) Do not discuss with:– Other patients– Relatives and friends of the patient– Visitors to the hospital– Representatives of news media– Fellow workers, except when in conference– Your own relatives and friends12/4/2015Legal Responsibilities in Health Care28

Confidential Information Information cannot be told to anyonewithout written consent of the patient The consent should state the following:– What information is to be released– To whom the information is to be given– Any time limits12/4/2015Legal Responsibilities in Health Care29

HIPAA Health Insurance Portability & Accountability Actof 1996 (HIPAA) Enacted August 21, 1996 Required the secretary of the DHHS(Department of Health & Human Services) topublicize standards for the privacy of all healthinformation The goal was to protect personal informationwhile still allowing information to reach thoseneeded to properly provide treatment to thepatient12/4/2015Legal Responsibilities in Health Care30

HIPAA (continued) Each health care provider must havecertain policies in place to comply withthese guidelines Employees must follow certain policies forall the health care information theyencounter in the facility Each facility must make written policiesavailable to all employees12/4/2015Legal Responsibilities in Health Care31

Safeguards As a health care worker to comply withHIPAA here are some basic guidelines:– Protect the patient from exposure of the body– Knock and pause before entering a room– Draw curtains or close door when providingcare– Leave while visitors are with the patient12/4/2015Legal Responsibilities in Health Care32

Safeguards (continued) Do not listen when patientsmake phone calls Be aware of yoursurroundings and do notdiscuss a patient withinareas others couldoverhear (elevators,cafeteria, hallways, parkinglot, etc)12/4/2015Legal Responsibilities in Health Care33

Information Exempt from Privileged Certain information is exempt by law andmust be reported. This includes:– Births & deaths– Injuries caused by violence requiring policeintervention (assault & battery, abuse,stabbings)– Drug abuse– Communicable diseases and STD’s12/4/2015Legal Responsibilities in Health Care34

Health Care Records Belongs to the health care provider Patient has right to obtain copy of anyinformation in record Can be a legal record in court of law Must be properly maintained, kept confidentialand maintained for amount of time required bystate When destroyed after time permits, must beburned or shredded to maintain confidentiality12/4/2015Legal Responsibilities in Health Care35

Correcting Mistakes Do not erase or mark out mistakes madeon patient records Cross out errors with one single linethrough the information Insert correct information, initial and date12/4/2015Legal Responsibilities in Health Care36

Computer Security of Records To maintain confidentiality of computer records: Limit personnel who have access Use codes to prevent access to certaininformation Require passwords to access specificinformation on records Constantly monitor and evaluate computer use Make sure computer monitor is turned awayfrom heavy traffic areas when accessingrecords12/4/2015Legal Responsibilities in Health Care37

Scenario While working at thelocal healthdepartment, your bestfriend comes in for apregnancy test. Hertest is positive. Howshould you handlethis situation?12/4/2015Legal Responsibilities in Health Care38