Académique Documents
Professionnel Documents
Culture Documents
Prepared By:
Kamran Khan
Roll No. Smba 13025
Sec-A
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TERMINOLOGIES
Abuse
Crimes
Fraud
Violence
Assault
Defamation
Law
Battery
Delegation
Malpractice
Contracts
Document
Negligence
Contracts
Float
Torts
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CONTENTS
1. Introduction-4
2. General Legal Concepts of Nursing-5 to 9
3. Legal Aspect Regarding Restraints-9
4. Regulation of Nursing Practice-10
5. Contractual Arrangements in Nursing-10 to 11
6. Selected Legal Aspects of Nursing Practice-11 to 13
7. Areas of Potential Liability in Nursing-13 to 14
8. Legal Protection in Nursing Practice-14
9. Reporting Crimes, Torts, and Unsafe Practices-14 to 15
10. Legal Responsibilities of Nursing Students-15 to 16
11. Research on nurses knowledge of legal aspects of nursing in
Nigeria.-17 to 27
12. References-28
13. Document Outline-29
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Introduction
Legal Aspects of Nursing
As a nurse it has become an important necessity to be aware of the legal aspects associated with
caring and helping people in the health industry today. Unfortunately, the more and more
negligence cases there are the less and less people want to get into the health care field fearing
legal aspects and the inevitable law suites. The first nursing law created was that of nursing
registration in 1903.
The Tort Law is the legal aspects of the law that most nurses are more familiar with. This
is the law that involved malpractice and negligence cases which many nurses take the time to
learn inside and out as this is one of the biggest fears in the medical community. Basically a Tort
is a wrongful act which produces harm, whether it is unintentional or intentional. Malpractice is a
specific type of Tort where the standards of care are not met. This is one of the most common and
familiar laws to nurses and something that nurses and doctors alike must be familiar with in order
to continue their care efficiently.
Nurses must take as many precautions as they can during their daily shifts. Recording,
documenting and reporting daily routines and decisions is one of the most common ways to make
sure on track with patience and in the right. Nurses learn in school that proper care of a patient is
not only making the right decisions but maintaining and organizing their medical records and
reports efficiently.
The legal aspects of nursing are taught and expected to be kept up on throughout every nurse's
career. A nursing job is something many young people aspire to but without the legal knowledge
behind them, many hospitals will not hire them now that legal issues are becoming more and
more problematic.
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It provides a framework for establishing which nursing actions in the care of client are
legal.
It differentiates the nurse's responsibilities from those of other health professional.
It helps establish the boundaries of independent nursing action.
It assists in maintaining a standard of nursing practice by making nurses accountable
under the law.
Types of law
Law governs the relationship of private individuals with government and with each other.
1. Public Law
One type of law is Public Law which deals with an individuals relationship to the state.
Sources include Constitutional, Administrative and Criminal These Sources occur on both
the Federal and State level
Set of basic laws that defines and limits the powers of government.
Nurse maintains rights as an individual.
Constitutional Rights, Civil Rights, State Constitution.
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2. Civil Law
The second type of law is Civil Law which deals with crimes against a person or persons in such
legal matters as:
Contracts
Torts
Protective Reporting Law
2.2. Tort Law is the enforcement of duties & rights among independent of contractual
agreements. It is a civil wrong committed on a person or property stemming from either a direct
invasion of some legal
Right of the person, infraction of some public duty, or the violation of some private obligation by
which damages accrue to the person.
Examples of Tort Law include:
Negligence and Malpractice
Assault and Battery
False Imprisonment
Restraints or Seclusion
Invasion of Privacy
Defamation
Fraud
and strive to achieve optimal outcomes. No maleficence means avoiding harm. Nurses must
maintain a competent practice level to avoid causing injury or suffering to clients. The principle
of no maleficence also covers reporting suspected abuse to prevent further victimization and
protecting clients from chemically impaired nurses and other healthcare practitioners. Autonomy
stands for independence and the ability to be self-directed. Clients have the right of selfdetermination and are entitled to decide what happens to them; therefore, competent adults have
the capacity to consent to or refuse treatment. Nurses must respect the client's wishes, even if they
don't agree with them. Finally, justice requires that all clients be treated equally and fairly. Nurses
face issues of justice daily when organizing care for their clients and deciding how much time
they will spend with each based on client needs and a fair distribution of resources.
Nurses need to distinguish between their personal values and their professional ethics. Personal
values are what nurses hold significant and true for themselves, while professional ethics involve
principles that have universal applications and standards of conduct that must be upheld in all
situations. Nurses thus avoid allowing personal judgments to bias client care. They are honest and
fair with clients, and they act in the best interest of and show respect for them.
Since nurses address complex ethical and human rights issues on a regular basis, the American
Nurses Association Board of Directors and the Congress on Nursing Practice first initiated the
Code of Ethics for Nurses in 1985 to delineate the code of responsibilities and conduct expected
of nurses in their practice. Nurses are held responsible to comply with the standards of ethical
practice and to ensure that other nurses also comply. The code was revised in 2001 to include
issues of advancing nursing science and is based on the opinions and experience of a wide range
of nurses. The ANA approved nine provisions that address ethical practice issues such as
compassion and respect, the nurse's primary commitment to the patient, patient advocacy,
responsibility and accountability, duties, participation in the healthcare environment, advancement
of the profession, and collaboration. You can read or purchase the ANA Code of Ethics for Nurses
with Interpretive Statements at www.nursingworld.org.
Liability is an obligation one has incurred or might incur thru any act or failure to act.
Malpractice refers to the behavior of a professional persons wrongful conduct, improper
discharge of professional duties, or failure to meet the standards of acceptable care which result in
harm to another person.
Negligence (breach of duty) is the failure of an individual to provide care that a reasonable person
would ordinarily use in a similar circumstance. Defendant is the person being sued. Plaintiff is the
party who initiates the lawsuit that seeks damages.
Duty
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Breach of duty
Damage
Causation
1. Duty: Duty stands for a legal obligation owed by one person to another person. When
nurses care for clients, they assume the duty to care for them in a competent and diligent
manner. Nurses are expected to provide the degree of care ordinarily exercised by other
nurses practicing in the same nursing specialty. Therefore, nurses are expected to adhere to
standards of carethose imposed by the nurse's state board of nursing nurse practice act,
the national nursing specialty standards of care and scope of practice, and the nurse's
hospital, or other agency, protocols.
2. Breach: A breach of duty takes place when there is failure to fulfill the duties established
as being the responsibility of the nurse. In other words, nurses breach their duty when they
do not meet the appropriate standard of care.
3. Causation: Causation is the most difficult element to prove because it is the factual
connection between what the nurse did and the injury to the client. Causation means that
the nurse's breach of duty, or failure to meet the appropriate standard of care, caused the
client's injury or adverse outcome.
4. Damages: Damages are monetary payments designed to compensate the client for the
injury or adverse outcome, and are intended to restore the plaintiff to the condition he or
she was in prior to the injury. To recover damages, the client must establish that he or she
suffered physical, financial, or emotional injury caused by the nurse's violation of the
standard of care. Damages are usually compensatory or punitive.
Nurses and nursing students can be held liable for their actions, and thus can be sued. However,
the majority of nurses are competent professionals who provide a satisfactory level of care.
According to HRSA's 2003 National Practitioner Data Bank (NPDB), only about 1 in 50
malpractice payment reports were for nurses. All levels of RNs were responsible for 4,512, or
1.8%, of malpractice payments over the history of the NPDB. Other classified RNs were
responsible for 63.3%, and included nurse anesthetists, nurse midwives, and nurse practitioners.
Reasons for malpractice payment reports varied depending on the type of nurse, but included
monitoring, treatment, and medication problems.
High-level-need clients and short staffing can increase the chances for error, but nurses can
minimize their liability by focusing on risk management. Healthcare facilities provide various
levels of in-service education on risk management, and nurses can take continuing education
courses on this important topic. Some states require risk management education courses for
license initiation and/or renewal. Florida requires a course on reducing medical errors, while Ohio
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requires nurses to take a course to become familiar with their state nurse practice act. Taking a
risk management course can also have some monetary advantagesome nursing malpractice
insurance companies give discounts on premiums to those who complete a risk management
course.
4. Restraints should not interfere with any treatments or affect the clients health
Problems.
5. Document the following:
Reason for the restraints
Method of restraints
Date and time of application
Duration of use and clients response
Release from the restraints (every 30 minutes) with periodic exercise and
Circulatory, neurovascular and skin assessment
Evaluation of clients response
6. DONT ASK PERMISSION IF THE PATIENT HAS AN ALTERED LEVEL
OF CONSCIOUSNESS!!!
7. If the client is unable to give consent to a restraint procedure, then consent of proxy
Must be obtained AFTER FULL DISCLOSURE OF ALL RISK AND BENEFITS.
8. Use a clove hitch knot so that restraint can be changed and release easily and
Ensure
evaluated.
Type the date of the contract and the names of those entering into the nursing contract.
Type the agreements made by both parties as to what will transpire during the term of
employment. This is the start date and the position and duties of the employee.
Type in any benefits that will be included in the compensation package. Insurance
coverage, pension payments and any other incentive compensation plans will be covered
here.
Expiration of the contract will be inserted next. The option of renewing the contract is
included. The terms of different scenarios will be spelled out.
Insert the reasons the contract would be terminated and what payments would be received
if the termination is enforced. The employee agrees to the confidentiality of the employer.
Informed Consent
procedure is more invasive and/ or the potential for risk to the client is great, a written
permission is needed.
Implied consent exists when the clients nonverbal behaviour indicates agreement such as
in positioning their bodies for an injection or when their vital signs are recorded.
Obtaining an informed consent for specific medical or surgical procedure is the responsibility of
the person who performs the procedure.
Information to be given to a Client to Make an Informed Decision 1.
Diagnosis or condition that requires treatment.
Purpose of treatment.
What the client can expect to feel or experience.
The intended benefits of the procedure.
Possible risks.
Advantages and disadvantages of alternatives to treatment (including no treatment)
What are the Major Elements and Exceptions of Informed Consent?
3.
In the United States, nurses could be liable for interfering with the client-provider
relationship.
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Delegation
Delegation is the transfer of responsibility for the performance of an activity from person to
another while retaining accountability for the outcome.
In the USA, the process of delegation is governed by laws and regulations such as the Nurse
Practice Act (NPA), the Unlicensed Assistive Personnel (UAP) job description and skill level. The
NPA defines and describes the scope of nursing practice.
When delegation is to occur, the nurse needs to determine the answers to the following questions:
Does the NPA permit delegation
Is there a list of procedure a nurse can delegate?
Are there guidelines explaining the nurses responsibilities when delegate
Violent behaviour can include domestic violence, human abuse, and sexual abuse.
Neglect is the absence of care necessary to maintain the health and safety of a client nurses
are in position to identify and assess cases of violence.
When an injury appears to be present resulting from abuse, neglect, or exploitation, the
nurse must report the situation to the appropriate authority.
Physician's Orders
The physician is in charge of directing the client's care, and nurses are to carry out the physician's
orders for care, unless the nurse believes that the orders are in error or would be harmful to the
client. In this case, the physician must be contacted to confirm and/or clarify the orders. If the
nurse still believes the orders to be inappropriate, the nursing supervisor should be immediate
contacted and why the orders are not being carried out put in writing. A nurse who carries out an
erroneous or inappropriate order may be held liable for harm experienced by the client.
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Nurses are responsible for their actions regardless of who told them to perform those actions.
Floating
The nurse should be given an orientation to the new unit and will be held to the same standards of
care as are the nurses who regularly work on that unit.
Inadequate Staffing
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has established
guidelines for determining the number of staff needed for any given situation (staffing ratios).
When there are not enough nurses to meet the staffing ratio and provide competent care,
substandard care may result, placing clients at physical risk and the nurse and institution at legal
risk. The nurse in this situation should provide nursing administration with a written account of
the situation. A nurse who leaves an inadequately staffed unit could be charged with client
abandonment.
Critical Care
Because the monitors used in critical care units are not infallible, constant observation and
assessment of clients are required. This makes a 1:1 or a 1:2 nurse-client ratio imperative.
Furthermore, equipment must be checked regularly and on a schedule by the bio-medical
department.
Pediatric Care
Legislation in each state requires that suspected child abuse or neglect be reported. Legal
immunity is provided to the person who makes a report in good faith. When suspected child abuse
or neglect is not reported by health care providers, legal action, civil or criminal, may be filed
against them.
any allegations of abuse toward a vulnerable population; protect the patient's right to privacy; and
pay strict attention to avoid medication dosing errors.
Common-Sense precautions
Follow accepted procedures. Protect from possible lawsuits by always performing
procedures as taught and as outlined in the procedure manual of healthcare facility. If these
policies are incorrect or inadequate, work to improve them through the proper channels.
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Be competent in practice
Always responsible for own behaviour. Refuse to perform procedures for which have not
been prepared. Ignorance is not a legal defence.
Neither will lack of sleep or overwork be accepted as a legal reason for carelessness about
safety measures or mistakes.
Document well
The importance of keeping exact records of all treatments and medications, as well as a
record of a clients reactions and behaviour, cannot be overemphasized. The health record is the
written and legal evidence of treatment. The record is to reflect facts only, not personal
judgments. Careful and accurate documentation is vital for each clients welfare.
Careful documentation is perhaps the most important thing can do to protect against an
unjustified lawsuit. If do not document a treatment or medication, legally the measure is
considered not to have been done.
Accepting gifts from the client is unwise for several reasons. Some clients are considered
vulnerable adults (e.g., mentally ill, retarded, or confused individuals) exchange of gifts could
compromise professional position, and could be accused of coercing the client.
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ORIGINAL RESEARCH
Nurses Knowledge of Legal Aspects of Nursing Practice in Ibadan,
Nigeria
Abstract
Knowledge of law that establishes a profession is essential for the professional. Nurses practice
within an environment in which accountability is demanded by the professional body as well as
the communities they serve. This implies that the very nature of nursing practice requires nurses
to be vigilant about understanding of the law. However, there is paucity of empirical evidence of
nurses knowledge of legal aspects of nursing. This paper presents a report of a survey of nurses
knowledge of legal aspects of nursing in Nigeria.
The descriptive study utilized a 39-item questionnaire developed by the researchers to gather
information from 161 nurses from different categories of hospitals in Ibadan. A simple random
technique was used in selecting respondents in each ward of the settings. Data were analyzed
using descriptive statistics.
The sample consisted of 20 males (12.4%) and 141 females (87.6%) with varying years of
experience. Nurses have knowledge of general law of the land (58.4%) but the majority had
knowledge deficits of laws governing nursing practice (77.6%). About 57 %( 91) of nurses
indicated that their hospitals have institutional policies that govern how nurses practice but only
50% knew the content and intent of the policies.
The hallmark of professionalism is accountability. The best way to practice nursing effectively is
being highly knowledgeable about the science and art of nursing coupled with sound knowledge
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of the laws that establish; control and promote nursing practice. It is therefore recommended that
the stake holders in nursing be more involved in ensuring adequate knowledge of legal aspects of
nursing practice to achieve the Nursing goal of quality care.
INTRODUCTION
Nursing encompasses autonomous and collaborative care of individuals of all ages, families,
groups and communities, sick or well and in all settings. Nursing includes the promotion of
health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion
of a safe environment, research, participation in shaping health policy and in patient and health
systems management, and education are also key nursing roles. Nursing also includes the use of
clinical judgment in the provision of care to enable people to improve, maintain, or recover
health, to cope with health problems, and to achieve the best possible quality of life, whatever
their disease or disability, until death]. Nursing involves the protection, promotion, and
optimization of health and abilities; prevention of illness and injury; alleviation of suffering
through the diagnosis and treatment of human responses; and advocacy in health care for
individuals, families, communities, and populations. The nurse assists the individual, sick or well,
in the performance of those activities contributing to health or its recovery (or to peaceful death)
that s/he would perform unaided if s/he had the necessary strength, will or knowledge.
Nursing practice varies both through its various specialties and countries; however, the authority
for the practice of nursing is based upon a social contract that delineates professional rights and
responsibilities as well as mechanisms for public accountability. In almost all countries, nursing
practice is defined and governed by law, and entrance to the profession is regulated at the national
or state level.
From all the perspectives of nursing above, it is evident that nursing is highly interactive. It then
becomes an important necessity for the nurse to be aware of the legal aspects associated with
caring and helping people in the health care industry today. Unfortunately, more negligence cases
are occurring and in western societies, less people want to get into the health care field, fearing
legal aspects and the inevitable law suits.
The first nursing law created was that of North Carolina in the US (permissive licensure for
nurses) in 1903 and it has evolved and expanded over the years to become a thick book which
every aspiring nurse must study today to understand their scope of practice.
This is because every nursing specialty has legal considerations/implications for the practitioner.
Apart from the interactions, documentation of such activities/interactions is very important.
18 | P a g e
Documentation is legal tender for any nursing interaction and care. It is usually treated as a legal
issue which the nurse must take very seriously.
In Nigeria, the regulation of nursing profession is by legislation and this is based on the code of
ethics of the International Council of Nurses. The Professional Association of Trained Nurses of
Nigeria succeeded in convincing the Nigerian government to regulate Professional Nursing by
legislation as in other countries and the first law was in 1946. The Nurses Act was reviewed in
1970. The Act translated the basic principles of the Nurses code of ethics to enforceable rules of
law. However this Act was reviewed and re-written in 1979 under the then Federal Military
Government and is cited as the Nursing and Midwifery decree 1979. It is also known as the
Nursing and Midwifery Principal Act. The Act was further amended in 1988 and 1992
respectively. The Decree established the Nursing and Midwifery Council of Nigeria and saddled
it with the responsibility of regulating and controlling the practice of the profession in its entire
ramification as put in paragraph (d) subsection 2 of section (1) of the decree. In addition to the
above, the Council is also to maintain discipline, establish and maintain a register of those
entitled to practice the profession.
Employment as a nurse requires a nursing degree as well as knowledge of the Nursing laws that
will apply should there be a misunderstanding or challenge by a patient or their family. Many
hospitals are not willing to hire nurses without the legal knowledge now that legal issues are
becoming more problematic. In order to avoid liability and guard against negligence or
malpractice suits, the nurse must be aware of the legal responsibilities of each aspect of the
nursing role. The primary goals of professional accountability in nursing are to maintain high
standards of care and to prevent the patients from harm. Nurses should be aware of and be
responsible for each action taken, be able to defend their actions and be willing to accept the
consequences of their actions. Personal accountability increases with the degree of autonomy, the
higher the degree of autonomy, and the greater the accountability. The public trust in a profession
increases proportionately to the degree in which the professional members guard and protect the
publics interest. Therefore it is imperative for nurses to be accountable to themselves for proper
use of their knowledge and skill in providing care. The Tort Law is the aspect of the law that most
nurses are more familiar with. This is the law that involves malpractice and negligence cases.
Basically a Tort is a wrongful act which produces harm, whether it is unintentional or intentional.
Malpractice is a specific type of Tort where the standards of care are not met. Common ground
for torts is invasion of privacy; assault; battery; false imprisonment; fraud and defamation either
as libel or slander. Nurses are affected by law as citizens; as employees and as service providers.
As important as the law appears to be in nursing practice, experience in Nigeria has shown that
nurses in the health care institutions (i.e. Primary, Secondary and Tertiary) behave as if they are
above the law and carry out nursing care as they deem fit. They have created an environment of
power relationship (i.e. superior-inferior relationship). A literature search revealed quite a lot of
information on nursing and the law but no studies were found on nurses knowledge of legal
aspects of nursing.
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Presently, in Nigeria, there is an ongoing campaign on the National Health Insurance Scheme
(NHIS). This will further put demands on nurses because if the scheme is finally and fully
embraced it will create room for litigation by the consumers of health care. It is against this
background that it becomes imperative to find out what knowledge practicing nurses in Nigeria
possess on legal aspects of nursing practice.
METHODOLOGY
The study was a descriptive survey on nurses knowledge of legal aspects of nursing practice in 4
settings. The choice of hospitals was informed by the ownership and types of services rendered
by each of the hospitals. The hospitals were as follows: University College Hospital (UCH),
Ibadan; Jericho Nursing Home (JNH), Jericho, Ibadan; Adeoyo Maternity Hospital, Ibadan; Ring
Road State Hospital, Ring Road, Ibadan; Alaafia Hospital, MO kola, Ibadan; and Catholic
Mission Hospitals, Oluyoro & Oke-Ofa. The study was intended to cover at least 30% of the
1,260 (target population) nurses who were in these settings. However, a total of 161 respondents
questionnaires were finally analyzed due to incomplete responses of the target population. This
figure eventually constitutes 13% of the target population. A simple random sampling technique
was employed in each ward at the various settings. One out of every three nurses whose names
appeared on the duty roster was selected in each ward. A table of random numbers was used in
selecting the nth nurse after the first nurses had been selected using the same instrument.
The survey instrument was a 39-item questionnaire designed by the researchers after a series of
literature reviews. The questionnaire was divided into two major sections, A and B. Section A
dealt with the socio-demographic characteristics of respondents and it consisted of 6 questions.
Section B consisted of 33 questions addressing the three study objectives. Each item in section B
was assigned one mark, this mean that the total obtainable score is 33. The instrument was pre20 | P a g e
tested among twenty (20) nurses at the General Hospital Ogbomoso. The pre-test was followed
by a test re-test after four weeks using the same sample and a correlation coefficient ratio r = 0.7
was obtained.
Ethical approval was obtained from the UI -UCH IRB. Permission to carry out the study was also
obtained from each of the participating hospitals. Ethical issues such as informed consent:
freedom to participate or not to participate; anonymity of person and confidentiality of
information of participants were given due considerations and attention. At the individual level,
participation was voluntary based on informed consent. There was 100% retrieval rate even
though so many questionnaires were not completed thus limiting sample size. Data were analyzed
descriptively using Statistical Package for the Social Sciences (SPSS) version 16.
RESULTS
The below table shows the socio-demographic characteristics of respondents. The majority
(87.6%) of the respondents were females thus reflecting the preponderance of women in nursing.
The majority (87%) had more than five years of experience as nurses and only a few (8.1%) had a
single nursing qualification as against the practice in Nigeria where a nurse should have
additional qualification either as a registered midwife (RM) or registered in any other nursing
specialty.
Table 1. Socio-Demographic Characteristics of respondents
Variables
1. Age
Male
NO
Female
%
NO
Total
%
NO
< 30 yrs.
2
10.0
12
8.51
14
8.70
31 40 yrs 1 5.0 49 32.75 50 31.06 41-50 yrs 11 55.0 51 34.17 62 38.51 > 50 yrs 6 30.0
24 17.02 30 18.63 Age- unknown - - 5 3.55 5 3.1
Total
20
100.0
141
100.0
161
100.0
2. Religion
Christianity
Islam
Others
Total
3. Marital status
Single
Married
Out of Marriage
11
9
20
F
5
15
-
55.0
45.0
100
%
25.0
75.0
-
115
15
11
141
F
33
103
5
81.6
10.6
7.8
100
%
23.4
23.4
3.5
126
24
11
161
F
38
38
5
72.3
14.9
6.8
100
%
23.6
23.6
3.1
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Total
4. Years of
experience
< 5 yrs
6-10 yrs
11-15 yrs
16-20 yrs
21-30 yrs
Unknown
Total
5. Professional
Qualification
20
100
141
100
161
100
2
3
7
8
20
10.0
15.0
35.0
40.0
100
21
14
34
35
42
5
151
14.89
9.93
24.11
17.73
29.79
3.5
100
21
16
37
32
50
5
161
13.04
9.94
22.98
19.88
31.06
3.1
100
RN only
RN, RM
RN with others
Total
6. Work place
6
14
20
30.0
70.0
100
7
115
19
141
5
81.5
13.5
100
13
115
33
161
8.1
71.4
20.5
100
Teaching hospital 3
State hospital
12
Mission hospital 4
Private hospital 1
Total
20
15.0
60
20
5.0
100
72
48
12
9
141
51.1
34
8.5
6.4
100
75
60
16
10
161
46.6
37.3
9.9
6.2
100
Good knowledge
Poor knowledge
Total
NO
149
103
147
133
38
10
52
33
94
31
%
92.5
64
91.3
82.6
23.6
6.2
32.3
20.5
58.4
19.2
NO
12
58
14
28
123
151
109
128
67
130
%
7.4
36.1
8.7
17.4
76.4
93.8
67.7
79.5
41.6
80.8
NO
161
161
161
161
161
161
161
161
161
161
%
100
100
100
100
100
100
100
100
100
100
45
99
28.0
61.5
116
62
72.0
38.5
161
161
100
100
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Assault
Slander
Defamation
Negligence
Malpractice
Law from N&MCN
70
98
85
120
104
26
43.5
60.9
52.8
74.5
64.6
16.1
91
63
76
41
57
135
56.5
39.1
47.2
25.5
35.4
83.9
161
161
161
161
161
161
100
100
100
100
100
100
The table shows that respondents have varying knowledge of the concept of law. However,
respondents demonstrated poor knowledge in common law (93.8%); Nursing and Midwifery
Council of Nigeria as an established administrative agency (80.8%); criminal law (79.5%);
statutory law (72.0%); and Administrative law (67.7%).
Total
Variables tested
Legal foundation of nursing
Registration act
Years of Nursing & Midwifery
decrees
The principal Act
Schedule of the Act
Amendment of the Act
Awareness of Institutional policies
Knowledge of contents of
institutional policies
NO
41
136
14
%
25.5
84.5
8.7
NO
120
25
147
%
74.5
15.5
91.3
NO
161
161
161
%
100
100
100
47
32
22
91
81
29.2
19.9
13.7
56.5
50.3
114
129
139
70
80
70.8
80.1
86.3
43.5
49.7
161
161
161
161
161
100
100
100
100
100
The above table shows respondents knowledge of law establishing nursing in Nigeria. The
majority of the respondents had poor knowledge of the legal foundation of nursing in Nigeria
while almost all respondent (91.3%) did not know the years the nursing and midwifery decrees
were promulgated.
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Variable tested
Protection of the society against
malpractice
Framework for nursing actions
Delineation of nursing actions
Ensures standard of practice
Protection of the professional nurse
Regulation of inter professional
interaction
Enhancement of professionalism
NO
114
%
70.8
NO
47
%
29.2
NO
161
%
100
115
66
134
55
126
71.4
41.0
83.2
34.2
78.3
46
95
27
106
35
28.6
59.0
16.8
65.8
21.7
161
161
161
161
161
100
100
100
100
100
120
74.5
41
25.5
161
100
This table shows nurses knowledge of the function of law in nursing. Respondents showed good
knowledge in the following areas: standards of practice (83.2%); regulation of inter professional
interaction (78.3); enhancement of professionalism (74.5); framework for nursing actions (71.4);
and protection of the society against malpractice (70.8%).
Table 5. Summary of result of the study
Characteristics
Good knowledge
Poor knowledge
Total
Variables
Knowledge of general law
Knowledge of law governing
nursing
Knowledge of function of law in
nursing
F
94
36
%
58.4
22.4
F
67
125
%
41.6
77.6
F
161
161
%
100
100
127
78.9
34
21.1
161
100
This table shows the summary of the results of the study. About 58.4% of respondents
demonstrated good knowledge of general law while 78.9% had good knowledge of the function
of law in nursing. Poor knowledge of law governing nursing was demonstrated by 77.6% of the
respondents.
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DISCUSSION
This study was designed to elicit how much nurses know about the laws that affect their practice.
The discussion will be treated according to the objectives of the study.
understanding terms and concepts that are essential in instituting legal action against the nurse
and incorporating the appropriate risk reduction practices into daily practice.
CONCLUSION
This study surveyed nurses knowledge of legal aspects of nursing practice; it presented the
results and discussed the findings. The results showed that Nigerian nurses have varying
knowledge of the legal aspects of nursing. Essentially, there were knowledge deficits on laws that
govern nursing practice and the various hospital or institutional policies among the nurses under
study. The results of the study imply that Nigerian nurses have left what should be the foundation
stone and built on a weak structure. There is no way one can practice nursing effectively without
being knowledgeable on the laws that establish, control and promote nursing practice. A nurse
with sound knowledge of the legal aspects of nursing will remain an asset to the profession.
infringed upon. With the advent of new technology, changing state and federal laws, and new
court decisions, the ethical and legal issues nurses will encounter when taking care of patients
will not remain the same. Continuing education will be essential if nurses are to remain current,
lower their malpractice liability, and deliver quality care. This is even more important in this era
of multinational nursing practice resulting from recruitment of nurses from different parts of the
world as part of the efforts to reduce nurse-shortage. It is with the achievement of litigationfree
service that nursing practice can be seen to be achieving its purpose in society.
RECOMMENDATIONS
In view of the findings of this study, the investigators recommend the following:
1)
Emphasis should be placed on legal aspects of nursing in the first year of nursing
education and much attention should be paid to its understanding.
2)
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References
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DOCUMENT OUTLINE
A contract is an agreement between two parties as to what will transpire and the rules and
regulations governing the service that will be provided. The legal agreement is enforceable by law
and those who sign the agreement must be able to legally enter into a contract. This means they
must be of legal age and they must have the mental capacity to sign a contract. Although not all
services are required to have a legal and binding contract, there are many that are governed by
statutory law such as nursing services. A contract is an agreement between two parties as to what
will transpire and the rules and regulations governing the service that will be provided. The legal
agreement is enforceable by law and those who sign the agreement must be able to legally enter
into a contract. This means they must be of legal age and they must have the mental capacity to
sign a contract. Although not all services are required to have a legal and binding contract, there
are many that are governed by statutory law such as nursing services. Instructions to Write a
Contract for Nursing Services:
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