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Question: What are the most common potential legal liabilities for nurse administration and nurse managers in health care settings? How can these areas of potential liability be minimized or avoided?

19 Mar 2023,6:34 PM

 

 

Discussion Question:

• Are there areas in which advanced nursing practice is making more of an impact than others? Do these correspond with the primary purposes of advanced nursing practice?

OR

• What are the most common potential legal liabilities for nurse administration and nurse managers in health care settings? How can these areas of potential liability be minimized or avoided?

 


This module begins by outlining the relationship between state nursing practice acts, entry into professional practice, educational issues, and scope of practice issues relevant to nursing and advanced nursing roles. The legal constraints to advanced professional practice encountered by nurses educationally and clinically competent to perform these roles will be explored. This module explains key concepts underlying nursing management, including supervision of others, the temporary reassignment of nurses to units other than those which they have primary expertise, and cases involving HIV patients and nurses from a nursing management perspective. Lastly, this module explores the concepts of delegation and supervision and the legal liabilities that can ensue.

This module began with an overview of nurse practice acts, licensure, and the scope of practice. Credentials, proof of the qualifications of individuals, include both licensure and certification. Each state has a nursing practice act and an administrative board of nursing that regulates registered and practical nursing practice. Professional nursing organizations and licensing boards offer certification for nurses in advanced clinical practice roles and advanced nursing practice. The major legal challenges involving advanced practice nurses have centered on scope of practice, standards of care, and malpractice issues. Legal issues that must be addressed in the future if advanced practice nurses are to be allowed to fully practice include issues directed at reimbursement, prescriptive authority, admitting privileges, and direct access to patient populations.

In the area of management, it is important to remember that nurse-managers are both employees and employers. As a manager, the nurse has an obligation to be aware of pertinent laws and litigation that may affect what managers may or may not do. As employees, nurse managers have many of the same rights as staff nurses. The effective manager will balance these two concepts to enhance patient care delivery. Finally, the module concluded with a focus on the legal aspects of delegation and supervision. The concept of delegation has evolved into allowing a variety of unlicensed assistive personnel to perform multiple nursing care tasks under the direct supervision of licensed professionals. These unlicensed caregivers assume the responsibility for the tasks performed, but not the accountability for the task. This module concluded with an exploration of the potential legal liabilities pertaining to the expanded concept of delegation, and presented a means of effectively delegating tasks from a legal perspective.

 

Module Goals
Differentiate among various types of licensure, including mandatory, permissive, and institutional
Articulate the process for creating state boards of nursing and their authority, including limitations on their authority
Analyze the legal constraints to advanced professional practice, including scope of practice, malpractice, standards of care, and prescriptive authority
Compare and contrast the doctrines of respondeat superior, vicarious liability, and personal liability from a nursing management perspective
Define the issues concerning temporary staffing from the aspect of legal liability
Differentiate delegation from assignment and supervision
Evaluate the role of unlicensed assistive personnel in relationship to professional accountability
Learning Materials


Required Resources:
Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Prentice Hall. ISBN: 9780134701233. Read Chapters 12, 13, 16, & 17.
Additional Resources:
Guido:
Ch 12: Nurse Practice Acts, Licensure and the Scope of Practice
Ch 13: Advanced Nursing Practice Roles
Ch 16: Nursing Management and the Nurse Manager
Ch 17: Delegation, Supervision and Selected Patient Advocacy Issues

Expert answer

 

In the healthcare industry, nurses play a vital role in providing care to patients. As a result, they are held to high standards of care, and nurse administrators and managers are tasked with ensuring that their staff are compliant with regulatory requirements and adhere to the best practices in patient care. However, in performing their duties, nurse administrators and managers are exposed to potential legal liabilities. This paper examines the most common potential legal liabilities for nurse administration and nurse managers in healthcare settings and discusses strategies for minimizing or avoiding these areas of potential liability.

Common potential legal liabilities for nurse administration and nurse managers:

  1. Medical Malpractice

Introduction

In the healthcare industry, nurses play a vital role in providing care to patients. As a result, they are held to high standards of care, and nurse administrators and managers are tasked with ensuring that their staff are compliant with regulatory requirements and adhere to the best practices in patient care. However, in performing their duties, nurse administrators and managers are exposed to potential legal liabilities. This paper examines the most common potential legal liabilities for nurse administration and nurse managers in healthcare settings and discusses strategies for minimizing or avoiding these areas of potential liability.

Common potential legal liabilities for nurse administration and nurse managers

  1. Medical Malpractice

Medical malpractice is a common legal liability for healthcare providers, including nurse administrators and managers. Medical malpractice occurs when a healthcare provider breaches the standard of care owed to a patient, resulting in injury or harm to the patient. In nursing, medical malpractice can occur when a nurse fails to follow established protocols, administer medication incorrectly, or improperly assess or monitor a patient's condition. Nurse administrators and managers can be held liable for medical malpractice if they fail to provide adequate supervision and training to their staff, leading to medical errors and malpractice.

  1. Negligent Hiring and Retention

Nurse administrators and managers are responsible for hiring and retaining qualified nurses. Negligent hiring and retention can occur when a nurse is hired despite having a history of malpractice or disciplinary actions. Nurse administrators and managers can be held liable for negligent hiring and retention if they fail to conduct adequate background checks or ignore red flags during the hiring process. Negligent retention can occur if a nurse is allowed to continue working despite a history of poor performance or misconduct.

  1. Failure to Ensure Compliance with Regulatory Requirements

Healthcare facilities are subject to numerous regulatory requirements, including state and federal laws, licensing requirements, and accreditation standards. Nurse administrators and managers are responsible for ensuring that their staff comply with these requirements. Failure to ensure compliance can result in fines, loss of accreditation, and potential legal liability.

  1. Workplace Harassment and Discrimination

Workplace harassment and discrimination are common legal liabilities in all industries, including healthcare. Nurses may be subject to harassment or discrimination based on their gender, race, religion, or other protected characteristic. Nurse administrators and managers can be held liable for workplace harassment and discrimination if they fail to provide a safe and inclusive work environment, fail to investigate or address complaints of harassment or discrimination, or retaliate against employees who report such behavior.

  1. Violation of Privacy and Confidentiality

Patient privacy and confidentiality are protected by state and federal laws, including HIPAA. Nurse administrators and managers are responsible for ensuring that their staff adhere to these laws and regulations. Violations of patient privacy and confidentiality can result in fines, loss of accreditation, and potential legal liability.

Minimizing or Avoiding Potential Legal Liabilities

  1. Implementing Policies and Procedures

Nurse administrators and managers should implement policies and procedures to ensure that their staff comply with regulatory requirements, adhere to the standard of care, and respect patient privacy and confidentiality. Policies should be reviewed regularly and updated as needed to reflect changes in regulations or best practices.

  1. Providing Adequate Training and Supervision

Nurse administrators and managers should provide their staff with adequate training and supervision to ensure that they are competent and comply with established protocols. Supervisors should provide regular feedback and performance evaluations to identify areas for improvement and ensure that their staff are held accountable for their actions.

  1. Conducting Background Checks

Nurse administrators and managers should conduct thorough background checks on potential hires to identify any red flags that could indicate a history of malpractice or misconduct. Background checks should include criminal history, professional licenses, and references.

  1. Investigating Complaints of Harassment and Discrimination

Nurse administrators and managers should investigate all complaints of harassment 

and discrimination promptly and thoroughly. Investigations should be conducted impartially, and appropriate disciplinary action should be taken if the complaint is substantiated.

  1. Ensuring Compliance with Privacy and Confidentiality Laws

Nurse administrators and managers should implement policies and procedures to ensure that patient privacy and confidentiality are protected. Staff should receive regular training on privacy and confidentiality laws and be held accountable for any violations.

  1. Maintaining Accurate Records

Accurate and complete records are essential in minimizing potential legal liabilities. Nurse administrators and managers should ensure that their staff maintain accurate and complete records of patient care, including documentation of assessments, interventions, and outcomes.

Conclusion

In conclusion, nurse administration and nurse management in healthcare settings are exposed to potential legal liabilities. The most common potential legal liabilities for nurse administration and nurse managers include medical malpractice, negligent hiring and retention, failure to ensure compliance with regulatory requirements, workplace harassment and discrimination, and violation of privacy and confidentiality. Strategies for minimizing or avoiding these areas of potential liability include implementing policies and procedures, providing adequate training and supervision, conducting background checks, investigating complaints of harassment and discrimination, ensuring compliance with privacy and confidentiality laws, and maintaining accurate records. By implementing these strategies, nurse administrators and managers can reduce their legal liabilities and promote high-quality patient care.

References:

American Nurses Association. (2015). Nursing: Scope and standards of practice. Silver Spring, MD: Nursesbooks.org.

DeLaet, D. (2008). Medical malpractice and the U.S. health care system. Journal of Public Health Policy, 29(1), 26-49.

Joint Commission. (2020). Accreditation standards for hospitals. Oakbrook Terrace, IL: Author.

Kumari, S., & Kumari, S. (2016). Nurse managers' role in avoiding legal issues. Nursing and Midwifery Research Journal, 12(3), 133-140.

National Council of State Boards of Nursing. (2017). Nurse practice act, rules and regulations. Chicago, IL: Author.

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