If a patient is trying to leave against medical advice and I physically block the door, that's false imprisonment and that is an intentional tort. And then I can compare notes, right? 5. And then B is where you carry out that threat and actually do patient harm. The provider can't write a PRN order for restraints, so there is no such thing as an order that says "apply restraints as needed." The tort of invasion of privacy is violating a patients right to confidentiality. Law Prof. We'll also explain a legal requirement for nursesmandatory reporting of suspicion of abuse, including the information required for reporting, and ways to help your patient get to safety. This is a plan for the patient to escape at a later time, including what to do, where to go, what kind of "go bag" to pack. I'm going to go over here. Practice according to current standards of practice. Unintentional torts are unintended acts against a patient that cause harm. Now let's talk about unintentional torts. Which tort involves intentional touching without the client's consent? A nurse may be charged with fraud for documenting interventions not performed or for altering documentation to cover up an error. Fry, S. T. (1989). Unintentional torts, on the other hand, are . When nursing home care kills or injures vulnerable elderly nursing home residents, tort litigation is necessary to hold facilities accountable. So a nurse who puts restraints on a patient for his or her own convenience, that would be an example of false imprisonment. But something that the nurse could do in this scenario is develop a safety plan. In nursing torts, battery is the touching of a patient, without consent, that causes harm. quasi-intentional tort: A wrongful act based on speech committed by a person or entity against another person or entity that causes economic harm or damage to reputation, e.g., a defamation of character or an invasion of privacy. A tort is a civil wrong that causes harm to another person by violating a protected right. As the name may suggest, these are unintended acts that may cause a patient harm. [17], The second element of malpractice is breach of duty. Nurses Service Organization and CNA Financial. So that is a very important distinction. Willful and intentional means that the act was done knowingly and on purpose. Unintentional torts occur when the defendants actions or inactions were unreasonably unsafe. Now battery, on the other hand, is actually the touching of a patient without consent that causes harm. This requires expert testimony from a physician because it requires a medical diagnosis. Crimes are classified as felonies, misdemeanors, and infractions. Nurses should be aware of the county or state agencies to whom they should report suspected abuse. However, most nursing home abuse and negligence cases go unreported and unknown to an elderly person's loved ones. Documentation is extremely important if you have a patient in restraints. Read additional information about signs of child and elder abuse in the Trauma, Abuse, and Violence chapter. So A is for assault and that's where you threaten the patient. The GI Bleed is the injury or damage. And a new order is required every 24 hours if restraints are still needed. These actions go against some or all of the nursing ethics we covered earlier in this series. So I didn't mean to do it, but it still caused harm. So willful and intentional being the key words. Physical injuries include loss of function, disfigurement, physical or mental impairment, exacerbation of prior medical problems, the need for additional medical care, and death. I hope that review was helpful. An area of civil litigation, "intentional torts" are defined by knowingly or purposefully caused harm. Clients bringing a malpractice lawsuit must be able to demonstrate to the court that their interests were harmed. The fourth intentional tort that I want to go over here is invasion of privacy. But every 4/2/1 hours they have to assess the patient and document that they still need to be restrained, which is not a new order, so it's more like a "refill." Nurses must take care in their oral communication and documentation to avoid defaming clients or coworkers. 4. Reasonably prudent means someone of sound mind and good reasoning capabilities. This is another example of nurses being held to a higher standard because of their job and licensingif a random person suspects abuse, they are not legally required by any laws or regulations to report it, but nurses are. Check out our Fundamentals of Nursing Flashcards. Because restraints are a last resort, their use is often audited. In our Psychiatric Mental Health series, we cover signs of abuse. But, torts are also important to consider from the psychiatric mental health perspective, because of the crucial differences between false imprisonment and restraints. Restraints (as a last resort) prevent patients from causing harm. A person bringing the lawsuit is called the plaintiff, and the parties named in the lawsuit are called defendants. That would be negligence - where you had a duty to act, for instance, and then you failed to act in the correct capacity. What do I need to do though? More and more nurses are being named defendants in malpractice lawsuits, according to the National Practitioner Data Bank (NPDB). So if you have a better way to remember, please tell me below, but if you like that one, go ahead and like this video for us so that we know. State laws vary, but they generally include a definition of abuse, a list of people required to report abuse, and the government agency designated to receive and investigate the reports. Confidentiality is the right of an individual to have personal, identifiable medical information, referred to as protected health information, kept private. Individuals required by state law to report suspected neglect or abuse of children, adults at risk, and the elderly. The bill, H.B. Patients have a right to the least restrictive environment, and so the least restrictive restraints possible should always be chosenin many cases, that option is hand mittens. [5], An example related to assault and battery in health care is the patients right to refuse treatment. In nursing torts, battery is the touching of a patient, without consent, that causes harm. The elements of standard of care, Plus your chicken icon helped. PRN means pro re nata, Latin for take as needed. So certainly things happen, right? These legal obligations are referred to as the duty of reasonable care. Types of acts that may lead to intentional torts . This is where you inappropriately confine a patient with restraints or even a chemical restraint, such as a sedative, when it's not appropriate. A restraint can be physical or chemical. It's the following through of that threat. So when it comes to torts, we have intentional torts and unintentional torts. McGraw-Hill Concise Dictionary of Modern Medicine. For example, if you were to say, "If you don't stop acting up, I am going to tie you down," or "I am going to hit you," those would be threats against a patient and thus, assault. Federal regulations to ensure the privacy and protection of personal records and information. But you, as the nurse, did NOT do that. The type of torts involved can be classified as negligence (unintentional), Assault or Battery (intentional). S.B. Negligence is failure to provide care that a reasonably prudent person would do under similar circumstances, whereas malpractice is negligence by a professional, so like a nurse. Introduction to law in nursing 9 Law and Pro 2013 B_gk.qxd 28/11/13 10:45 Page 9 Thanks so much for watching, and happy studying! Torts can be categorized as intentional or unintentional Intentional Torts An intentional tort is a willful act that violates a patient's rights. Intentional Tort Example Assault The conduct of one person makes another person fearful and apprehensive (threatening to place a nasogastric tube . After torts we'll explain restraints, then we'll summarize the key differences between false imprisonment and restraints. A type of tort that can only result from an intentional act of the defendant. There are numerous specific torts including trespass, assault, battery, negligence, products liability, and intentional infliction of emotional distress. Failing to do so creates an assumption of departure from standards. Remember we do have some cool chicken hints coming up, so these are fun ways of remembering things. Want to create or adapt books like this? Mittens are least restrictive. The correct procedure must be followed every time. See Malpractice, Negligence Opthalmology verb To rotate an eye on its anteroposterior axis. The provider MUST do an in-person assessment within 24 hrs of initiation of restraints or seclusion. 6 min read. So the way I remember is A comes before B. I can document the inconsistencies or the consistencies in the stories. then separately interview the parent and ask, "how did your child break their arm?" The specific rights protected give rise to the unique "elements" of each tort. This series follows along with our Psychiatric Mental Health Nursing Flashcards which are intended to help RN and PN nursing students study for nursing school exams, including the ATI, HESI, and NCLEX. Slander is spoken defamation and libel is written defamation. So we have our cool chicken hint right here is A before B, right? About Us. CCRN Review. Try NURSING.com Risk Free for 3 Days. This standard is assessed on a case-by-case basis and can vary across different states. For example, a nurse may need to separate a patient from their suspected abuser or get security involved. ATI and Test of Essential Academic Skills are registered trademarks of Assessment Technologies Institute, which is unaffiliated, not a sponsor, or associated with Cathy Parkes or this website. They are open for calls 24 hours a day. Now, if I made a Facebook post about it, or if I hung up signs in the hospital saying something that was not true that was going to harm a patient or a staff member's reputation, that is libelL-I-B-E-L, libelbecause it was written. Brous, E. (2019). The misconduct must be outrageous or extreme. Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube in the right nostril. Unintentional torts are unintended acts against a patient that cause them harm. The consequence must be substantial including mortification, distress, or grief. [23], Determining the specific amount a plaintiff needs can require expert witness testimony from a person known as a life care planner who is trained in analyzing and evaluating medical costs, as well as the subjective determination of a jury. [22], There are several types of injuries for which patients or their representatives seek compensation. See the following box for additional information. regardless of whether they are brought in contract, tort, under a statute, or under any other cause of action. the right to leave even when it's against medical advice, Fundamentals of Nursing - Flashcards This includes unwarranted touching . So for example, if there is a patient in a hospital with a bedsore, which we call a pressure injury, and there are orders for wound care and also orders to shift the patient's weight every two hours. When determining whether or not a nurse owed a duty of care, and whether or not that duty was breached, the court will consider the standard of care appropriate for a nurse with similar education,. If, as a nurse, you don't do that, you fail to provide the wound care and you don't reposition the patient every two hours, and that wound deteriorates and causes sepsis - so that's the patient harm - then you would be guilty of nursing malpractice. And as nurses we are mandatory reporters, meaning that by law, we are required to report any suspicion of abuse for a child, a vulnerable adult, or an elder. Injuries can be physical, emotional, financial, professional, marital, or any combination of these. While your patient is in restraints, you need to: assess them, like lay eyes on them every 15 minutes, and then every 2 hours you need to take their vital signs, you need to provide range of motion exercises, you should check their skin integrity like under the restraints, and provide fluids and toileting. Physical harm does not need to occur in order to be charged with assault or battery. 7 min read Assault is the intentional act of making someone fear that you will cause them harm. Nurses must practice according to the Nurse Practice Act of the state in which they are providing client care. The nurse just has the requirement to report the facts, circumstances and observations that led them to suspect abuse and neglect. (2020, June). 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